Provider Demographics
NPI:1508117177
Name:NOBLES, RICHARD HARRIS JR (PHD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:HARRIS
Last Name:NOBLES
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13725 METCALF AVE STE 508
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-7899
Mailing Address - Country:US
Mailing Address - Phone:913-308-6866
Mailing Address - Fax:
Practice Address - Street 1:13725 METCALF AVE STE 508
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-7899
Practice Address - Country:US
Practice Address - Phone:913-308-6866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-24
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012012270103TC0700X
MO2012012770103TC2200X, 103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO490000399Medicaid