Provider Demographics
NPI:1053887588
Name:NOACK, RICHARD ALEXANDER
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:ALEXANDER
Last Name:NOACK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 GOOSEBERRY DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-9612
Mailing Address - Country:US
Mailing Address - Phone:775-813-0815
Mailing Address - Fax:
Practice Address - Street 1:480 GALLETTI WAY
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-5564
Practice Address - Country:US
Practice Address - Phone:775-688-1633
Practice Address - Fax:775-688-1640
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-23
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor