Provider Demographics
NPI:1295044386
Name:EUBANKS, NORMA ELAINE (LCSW, PIP)
Entity Type:Individual
Prefix:MRS
First Name:NORMA
Middle Name:ELAINE
Last Name:EUBANKS
Suffix:
Gender:F
Credentials:LCSW, PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27625 US HIGHWAY 98 BLDG A
Mailing Address - Street 2:
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-4816
Mailing Address - Country:US
Mailing Address - Phone:251-626-7959
Mailing Address - Fax:251-626-6122
Practice Address - Street 1:27625 US HIGHWAY 98 BLDG A
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-4816
Practice Address - Country:US
Practice Address - Phone:251-626-7959
Practice Address - Fax:251-626-6122
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALLCSW 1372C101YP2500X
ALPIP 443 1372C101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional