Provider Demographics
NPI:1710996251
Name:NORMAN, JOANNE (MA,LMHC)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:NORMAN
Suffix:
Gender:F
Credentials:MA,LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3315 139TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-8661
Mailing Address - Country:US
Mailing Address - Phone:425-334-2195
Mailing Address - Fax:
Practice Address - Street 1:9429 N DAVIES RD
Practice Address - Street 2:
Practice Address - City:LAKE STEVENS
Practice Address - State:WA
Practice Address - Zip Code:98258-9444
Practice Address - Country:US
Practice Address - Phone:425-750-4937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH0009744101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health