Provider Demographics
NPI:1871294322
Name:NOGA, LAURA (LMSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:NOGA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 EDGEMERE AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06110-1004
Mailing Address - Country:US
Mailing Address - Phone:860-712-6361
Mailing Address - Fax:
Practice Address - Street 1:222 MAIN STREET EXT
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-4470
Practice Address - Country:US
Practice Address - Phone:860-530-4357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6444104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker