Provider Demographics
NPI:1417984667
Name:NORTON, DANIEL VICTOR (LCSWR)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:VICTOR
Last Name:NORTON
Suffix:
Gender:M
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 HARBOUR POINTE CMN
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14202-4305
Mailing Address - Country:US
Mailing Address - Phone:716-812-1568
Mailing Address - Fax:
Practice Address - Street 1:5820 MAIN ST
Practice Address - Street 2:STE. 308
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5776
Practice Address - Country:US
Practice Address - Phone:716-812-1568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0304201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000511136001OtherBC/BS
NYJ300083857Medicare PIN
NYR53908Medicare UPIN
NYA76341Medicare ID - Type Unspecified