Provider Demographics
NPI:1316647746
Name:NOELS, JAYSIA
Entity type:Individual
Prefix:
First Name:JAYSIA
Middle Name:
Last Name:NOELS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 TWIN STAR LN
Mailing Address - Street 2:
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-6647
Mailing Address - Country:US
Mailing Address - Phone:919-961-7395
Mailing Address - Fax:
Practice Address - Street 1:2321 CRABTREE BLVD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-3048
Practice Address - Country:US
Practice Address - Phone:919-848-9108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool