Provider Demographics
NPI:1124562343
Name:BITTLE, NORA LEE (LCSWA)
Entity Type:Individual
Prefix:MS
First Name:NORA
Middle Name:LEE
Last Name:BITTLE
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:MRS
Other - First Name:NORA
Other - Middle Name:LEE
Other - Last Name:WILLIAMS-BITTLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSWA
Mailing Address - Street 1:107 GRANDIN RD APT 11
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-4469
Mailing Address - Country:US
Mailing Address - Phone:704-819-1982
Mailing Address - Fax:
Practice Address - Street 1:107 GRANDIN RD APT 11
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-4469
Practice Address - Country:US
Practice Address - Phone:704-819-1982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-06
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0110341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical