Provider Demographics
NPI:1164582235
Name:NORFOLK, VIRGINIA LEE (LLPC)
Entity Type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:LEE
Last Name:NORFOLK
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 KENNELY RD
Mailing Address - Street 2:UNIT A-18
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48609-6775
Mailing Address - Country:US
Mailing Address - Phone:989-781-9589
Mailing Address - Fax:989-631-1039
Practice Address - Street 1:3611 N SAGINAW RD
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-2384
Practice Address - Country:US
Practice Address - Phone:989-631-3230
Practice Address - Fax:989-633-1039
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401007502101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional