Provider Demographics
NPI:1669353439
Name:NOE, TERRI RENEE (CADCA1)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:RENEE
Last Name:NOE
Suffix:
Gender:F
Credentials:CADCA1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 CUSTER DR STE 101
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-4010
Mailing Address - Country:US
Mailing Address - Phone:859-368-0434
Mailing Address - Fax:859-368-0437
Practice Address - Street 1:3150 CUSTER DR STE 101
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40517-4010
Practice Address - Country:US
Practice Address - Phone:859-368-0434
Practice Address - Fax:859-368-0437
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY293189101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty