Provider Demographics
NPI:1609128198
Name:NORMAN, M. BONNE (LMSW)
Entity Type:Individual
Prefix:
First Name:M.
Middle Name:BONNE
Last Name:NORMAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:MARTHA
Other - Middle Name:B
Other - Last Name:NORMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:2600 S SHORE BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-2943
Mailing Address - Country:US
Mailing Address - Phone:281-433-5032
Mailing Address - Fax:
Practice Address - Street 1:3 SUGAR CREEK CENTER BLVD
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3541
Practice Address - Country:US
Practice Address - Phone:281-317-7326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-08
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27858104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker