Provider Demographics
NPI:1194867663
Name:NORRIS, FERN (LMHP)
Entity Type:Individual
Prefix:MRS
First Name:FERN
Middle Name:
Last Name:NORRIS
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 EAST 39TH STREET
Mailing Address - Street 2:
Mailing Address - City:SOUTH SIOUX CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68776
Mailing Address - Country:US
Mailing Address - Phone:402-494-0040
Mailing Address - Fax:402-494-0050
Practice Address - Street 1:625 EAST 39TH STREET
Practice Address - Street 2:
Practice Address - City:SOUTH SIOUX CITY
Practice Address - State:NE
Practice Address - Zip Code:68776
Practice Address - Country:US
Practice Address - Phone:402-494-0040
Practice Address - Fax:402-494-0050
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1948101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE85379OtherBCBSNE
NE743064848-26Medicaid