Provider Demographics
NPI:1497270722
Name:NORRIS, WILLIE BRYON (LPC-A)
Entity Type:Individual
Prefix:
First Name:WILLIE
Middle Name:BRYON
Last Name:NORRIS
Suffix:
Gender:M
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420A S POLLOCK ST
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:NC
Mailing Address - Zip Code:27576-3404
Mailing Address - Country:US
Mailing Address - Phone:919-351-0428
Mailing Address - Fax:919-351-0814
Practice Address - Street 1:1420A S POLLOCK ST
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:NC
Practice Address - Zip Code:27576-3404
Practice Address - Country:US
Practice Address - Phone:919-351-0428
Practice Address - Fax:919-351-0814
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA13194101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional