Provider Demographics
NPI:1528593605
Name:NORVILLE, PRINCESS (LCSW-A, LCAS-A)
Entity Type:Individual
Prefix:
First Name:PRINCESS
Middle Name:
Last Name:NORVILLE
Suffix:
Gender:F
Credentials:LCSW-A, LCAS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 CLIFTON ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5008
Mailing Address - Country:US
Mailing Address - Phone:252-353-0100
Mailing Address - Fax:
Practice Address - Street 1:313 CLIFTON ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5008
Practice Address - Country:US
Practice Address - Phone:252-353-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-26
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21827101YA0400X
NCP0101881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)