Provider Demographics
NPI:1225270523
Name:HERSHEY, NORMA JEAN (LMFT LCPC)
Entity Type:Individual
Prefix:MRS
First Name:NORMA
Middle Name:JEAN
Last Name:HERSHEY
Suffix:
Gender:F
Credentials:LMFT LCPC
Other - Prefix:
Other - First Name:JEANIE
Other - Middle Name:
Other - Last Name:HERSHEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT LCPC
Mailing Address - Street 1:BOX 694
Mailing Address - Street 2:
Mailing Address - City:PAYETTE
Mailing Address - State:ID
Mailing Address - Zip Code:83661-0694
Mailing Address - Country:US
Mailing Address - Phone:208-739-6818
Mailing Address - Fax:208-642-2796
Practice Address - Street 1:695 2ND AVE S,
Practice Address - Street 2:NORTH ENTRANCE
Practice Address - City:PAYETTE
Practice Address - State:ID
Practice Address - Zip Code:83661-0694
Practice Address - Country:US
Practice Address - Phone:208-739-6818
Practice Address - Fax:208-642-2796
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-01
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC 830101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor