Provider Demographics
NPI:1164131876
Name:NORRIS, KERRY JANE (LSW)
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:JANE
Last Name:NORRIS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 SPEAR RD STE 107
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-1223
Mailing Address - Country:US
Mailing Address - Phone:201-639-4032
Mailing Address - Fax:
Practice Address - Street 1:121 WOODCLIFF AVE
Practice Address - Street 2:
Practice Address - City:WOODCLIFF LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07677-7935
Practice Address - Country:US
Practice Address - Phone:973-805-0609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SLO64970001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical