Provider Demographics
NPI:1336956283
Name:CLEARWATER, NOELLE RENEE (MA, AMFT)
Entity type:Individual
Prefix:
First Name:NOELLE
Middle Name:RENEE
Last Name:CLEARWATER
Suffix:
Gender:F
Credentials:MA, AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 N SAN MARCOS RD
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93111-1213
Mailing Address - Country:US
Mailing Address - Phone:805-617-6117
Mailing Address - Fax:
Practice Address - Street 1:970 EMBARCADERO DEL MAR
Practice Address - Street 2:
Practice Address - City:ISLA VISTA
Practice Address - State:CA
Practice Address - Zip Code:93117-4869
Practice Address - Country:US
Practice Address - Phone:844-594-0343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-13
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA133916106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist