Provider Demographics
NPI:1710502646
Name:NORTON, KEVIN EDWARD (LCSW)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:EDWARD
Last Name:NORTON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 ASPEN CT
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32327-0522
Mailing Address - Country:US
Mailing Address - Phone:850-510-0064
Mailing Address - Fax:
Practice Address - Street 1:54 ASPEN CT
Practice Address - Street 2:
Practice Address - City:CRAWFORDVILLE
Practice Address - State:FL
Practice Address - Zip Code:32327-0522
Practice Address - Country:US
Practice Address - Phone:850-510-0064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-16
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL132931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty