Provider Demographics
NPI:1699770560
Name:NOGGLE, TODD ALLEN (MS, LPC, NCC, LCPC)
Entity type:Individual
Prefix:MR
First Name:TODD
Middle Name:ALLEN
Last Name:NOGGLE
Suffix:
Gender:M
Credentials:MS, LPC, NCC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 E MILWAUKEE ST
Mailing Address - Street 2:STE 210
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53545-3061
Mailing Address - Country:US
Mailing Address - Phone:608-755-1475
Mailing Address - Fax:
Practice Address - Street 1:20 E MILWAUKEE ST
Practice Address - Street 2:STE 210
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53545-3061
Practice Address - Country:US
Practice Address - Phone:608-755-1475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3277-125101YP2500X
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI409-25-00Medicare ID - Type UnspecifiedMENTAL HEALTH COUNSELOR