Mark E Noll PHD PC – Clinical Psychologist

Key facts

NPI: 1720201007
Entity type: Organization (NPI type 2)
Primary specialty: Clinical Psychologist 103TC0700X
License: 20010455A (IN)
Legal business name: MARK E NOLL PHD PC
Practice address: 158 Napoleon St
Suite 104
Valparaiso, IN 46383-5529
Phone: (219) 465-7674
Fax: (219) 462-0329
NPI assigned: Apr 11, 2007
Organization subpart: No

Authorized official

Name: Dr. Mark E. Noll, PH.D.
Title: Psychologist
Phone: (219) 465-7674

National Provider Directory

Locations

158 Napoleon St
Ste 104
Valparaiso, IN 46383
Phone (219) 465-7674

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinical Psychologist Group: 193400000X SINGLE SPECIALTY GROUP	103TC0700X	20010455A	IN	Yes

Addresses

Primary practice location

158 Napoleon St
Suite 104
Valparaiso, IN 46383-5529

Mailing address

158 Napoleon St
Suite 104
Valparaiso, IN 46383-5529
Phone (219) 465-7674

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 27, 2010.

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272326400000",
    "number": "1720201007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 NAPOLEON ST",
            "address_2": "SUITE 104",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463835529",
            "telephone_number": "219-465-7674",
            "fax_number": "219-462-0329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 NAPOLEON ST",
            "address_2": "SUITE 104",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463835529",
            "telephone_number": "219-465-7674",
            "fax_number": "219-462-0329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK E NOLL PHD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2010-04-27",
        "status": "A",
        "authorized_official_last_name": "NOLL",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "219-465-7674",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20010455A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

All providers in Valparaiso, IN · Clinical Psychologist in Indiana

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 27, 2010. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.