Provider Demographics
NPI:1801308416
Name:PAULING, NOELLE (MS, MA, LPC, LPC/S-C)
Entity type:Individual
Prefix:MRS
First Name:NOELLE
Middle Name:
Last Name:PAULING
Suffix:
Gender:F
Credentials:MS, MA, LPC, LPC/S-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 STAMPORT CIR
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-9389
Mailing Address - Country:US
Mailing Address - Phone:803-250-1998
Mailing Address - Fax:
Practice Address - Street 1:401 WESTERN LN STE 9B-1
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-7953
Practice Address - Country:US
Practice Address - Phone:803-250-1998
Practice Address - Fax:866-598-4111
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-04
Last Update Date:2023-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6695101YM0800X, 101YP2500X
374K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPC2447Medicaid