Provider Demographics
NPI:1114414539
Name:NORRIS, CARLIE ANN (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:CARLIE
Middle Name:ANN
Last Name:NORRIS
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 REDBUD DR
Mailing Address - Street 2:
Mailing Address - City:TAYLOR MILL
Mailing Address - State:KY
Mailing Address - Zip Code:41015-2118
Mailing Address - Country:US
Mailing Address - Phone:859-620-5673
Mailing Address - Fax:
Practice Address - Street 1:714 REDBUD DR
Practice Address - Street 2:
Practice Address - City:TAYLOR MILL
Practice Address - State:KY
Practice Address - Zip Code:41015-2118
Practice Address - Country:US
Practice Address - Phone:859-620-5673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-20
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker