Provider Demographics
NPI:1063777894
Name:VITOR, NOELLE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:NOELLE
Middle Name:
Last Name:VITOR
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 126
Mailing Address - Street 2:
Mailing Address - City:BIG SUR
Mailing Address - State:CA
Mailing Address - Zip Code:93920-0126
Mailing Address - Country:US
Mailing Address - Phone:858-322-3567
Mailing Address - Fax:
Practice Address - Street 1:3255 CAMINO DEL RIO S
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3806
Practice Address - Country:US
Practice Address - Phone:858-322-3567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-09
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA216931OtherMASSACHUSETTS STATE BOARD OF BEHAVIORAL HEALTH