Provider Demographics
NPI:1609440981
Name:BAXTER, NORMA SUE SPRING (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:NORMA
Middle Name:SUE SPRING
Last Name:BAXTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SPRING
Other - Middle Name:
Other - Last Name:BAXTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:6485 W INTERCHANGE LN STE 110
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709-2102
Mailing Address - Country:US
Mailing Address - Phone:307-413-6097
Mailing Address - Fax:
Practice Address - Street 1:6485 W INTERCHANGE LN STE 110
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83709-2102
Practice Address - Country:US
Practice Address - Phone:208-696-4287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-19
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW1041C0700X
IDLCSW-444201041C0700X
ID104100000X
IDLMSW-40795104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker