Provider Demographics
NPI:1093380560
Name:NORRIS, PAUL EVERETT III (LSW)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:EVERETT
Last Name:NORRIS
Suffix:III
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7028 AMERICAN WAY APT B
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-2643
Mailing Address - Country:US
Mailing Address - Phone:317-603-1725
Mailing Address - Fax:
Practice Address - Street 1:7028 AMERICAN WAY APT B
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-2643
Practice Address - Country:US
Practice Address - Phone:317-603-1725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33008595A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health