Provider Demographics
NPI:1033117361
Name:NORTON, DAVID J (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:NORTON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 E MAIN ST
Mailing Address - Street 2:ST CHARLES
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-2287
Mailing Address - Country:US
Mailing Address - Phone:630-377-6613
Mailing Address - Fax:630-377-6225
Practice Address - Street 1:1120 E MAIN ST
Practice Address - Street 2:ST CHARLES
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-2287
Practice Address - Country:US
Practice Address - Phone:630-377-6613
Practice Address - Fax:630-377-6225
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor