Provider Demographics
NPI:1215941364
Name:FEDERLE, NOEL FEDERLE (MA, LPC)
Entity type:Individual
Prefix:
First Name:NOEL
Middle Name:FEDERLE
Last Name:FEDERLE
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:984 SOUTHFORD RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-3234
Mailing Address - Country:US
Mailing Address - Phone:203-758-2400
Mailing Address - Fax:203-758-2415
Practice Address - Street 1:984 SOUTHFORD RD
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:CT
Practice Address - Zip Code:06762-3234
Practice Address - Country:US
Practice Address - Phone:203-758-2400
Practice Address - Fax:203-758-2415
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000325101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional