Provider Demographics
NPI:1053926188
Name:NOGGLE, PHELICIA BERLIN
Entity type:Individual
Prefix:
First Name:PHELICIA
Middle Name:BERLIN
Last Name:NOGGLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 MERIDIAN ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1756
Mailing Address - Country:US
Mailing Address - Phone:360-676-6000
Mailing Address - Fax:
Practice Address - Street 1:3600 MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1756
Practice Address - Country:US
Practice Address - Phone:360-676-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health