Individual
JENNIFER NOONAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4900 BROADWAY, GARY, IN 46408-4605
(219) 237-5170
(219) 321-1931
Mailing address
PO BOX 746715, ATLANTA, GA 30374-6715
(773) 352-1515
(312) 929-0373
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
260380
KY
1041C0700X
Clinical Social Worker
Primary
34004751A
IN
1041C0700X
Clinical Social Worker
9290
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000333652
ANTHEM
IN
Enumeration date
08/02/2005
Last updated
04/12/2026
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