Provider Demographics
NPI:1033378377
Name:NORENSBERG, BRIAN D (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:D
Last Name:NORENSBERG
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4270 S DECATUR BLVD STE A10A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-6801
Mailing Address - Country:US
Mailing Address - Phone:702-912-5559
Mailing Address - Fax:702-912-5536
Practice Address - Street 1:4270 S DECATUR BLVD STE A10A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103
Practice Address - Country:US
Practice Address - Phone:702-912-5559
Practice Address - Fax:702-912-5536
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY0760103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical