Individual
DR. NOAH LYLES PHD MFT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD MFT
Contact information
Practice address
8112 MARYLAND AVE, CLAYTON, MO 63105-3729
(314) 474-9475
Mailing address
8112 MARYLAND AVE, CLAYTON, MO 63105-3729
(314) 449-3648
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
0089565
TN
101YP1600X
Pastoral Counselor
2009000351
MO
101YP2500X
Professional Counselor
0089565
TN
101YP2500X
Professional Counselor
Primary
2009000351
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
831317927
—
TN
01
—
85-2660293
MEDICAL BILLING
MO
05
—
85-2660293
—
MO
Enumeration date
08/03/2018
Last updated
11/23/2021
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