Basic Information
| Provider Information | |||||||||
| NPI: | 1225095193 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NORTON | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | |||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 747 INDIAN POINT ROAD | ||||||||
| Address2: | |||||||||
| City: | BRUTUS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 49716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2315904321 | ||||||||
| FaxNumber: | 5173468291 | ||||||||
| Practice Location | |||||||||
| Address1: | 5397 HOWARD ROAD | ||||||||
| Address2: | |||||||||
| City: | PETOSKEY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 49770 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2318387155 | ||||||||
| FaxNumber: | 5173468291 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2006 | ||||||||
| LastUpdateDate: | 06/17/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 6802080624 | MI | N | Behavioral Health & Social Service Providers | Social Worker | 104100000X | 6801092673 | MI | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.