Provider Demographics
NPI:1144193871
Name:NOONAN, ZACHARY SCOTT
Entity type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:SCOTT
Last Name:NOONAN
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:ZAC
Other - Middle Name:
Other - Last Name:NOONAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:821 N ST STE 102
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-3285
Mailing Address - Country:US
Mailing Address - Phone:907-917-3210
Mailing Address - Fax:
Practice Address - Street 1:821 N ST STE 102
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-3285
Practice Address - Country:US
Practice Address - Phone:907-917-3210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK240303104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty