Provider Demographics
NPI:1710292438
Name:NORSTROM, GAIL LEE (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:GAIL
Middle Name:LEE
Last Name:NORSTROM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 TOMPKINS ST
Mailing Address - Street 2:
Mailing Address - City:HEFLIN
Mailing Address - State:AL
Mailing Address - Zip Code:36264-1836
Mailing Address - Country:US
Mailing Address - Phone:256-463-2969
Mailing Address - Fax:256-463-5472
Practice Address - Street 1:150 TOMPKINS ST
Practice Address - Street 2:
Practice Address - City:HEFLIN
Practice Address - State:AL
Practice Address - Zip Code:36264-1836
Practice Address - Country:US
Practice Address - Phone:256-463-2969
Practice Address - Fax:256-463-5472
Is Sole Proprietor?:No
Enumeration Date:2010-08-18
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
AL1942C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical