Provider Demographics
NPI:1053655365
Name:NORRIS, GINA LINNET (MA, LLPC)
Entity Type:Individual
Prefix:MS
First Name:GINA
Middle Name:LINNET
Last Name:NORRIS
Suffix:
Gender:F
Credentials:MA, LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:11373 WHITCOMB ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48227-2013
Mailing Address - Country:US
Mailing Address - Phone:313-980-4022
Mailing Address - Fax:
Practice Address - Street 1:17356 WEST TWELVE MILE ROAD, SUITE 203
Practice Address - Street 2:PERSONAL CHOICE PLANNED CHANGE HUMAN SERVICES LLC
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076
Practice Address - Country:US
Practice Address - Phone:248-363-1976
Practice Address - Fax:248-481-3794
Is Sole Proprietor?:No
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI6401012901101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor