Provider Demographics
NPI:1518035674
Name:NORTON, GEORGANN (PSYD)
Entity Type:Individual
Prefix:
First Name:GEORGANN
Middle Name:
Last Name:NORTON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 S COLLIER BLVD
Mailing Address - Street 2:APT 203
Mailing Address - City:MARCO ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:34145-6457
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:501 GOODLETTE RD N
Practice Address - Street 2:STE D100
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5666
Practice Address - Country:US
Practice Address - Phone:708-361-5600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8519103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1622898OtherBCBS
IL071005300OtherLICENSE
IL1622898OtherBCBS