Provider Demographics
NPI:1720207095
Name:VAN NORT, JAMES JOHN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JOHN
Last Name:VAN NORT
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-2625
Mailing Address - Country:US
Mailing Address - Phone:502-585-3534
Mailing Address - Fax:502-585-3539
Practice Address - Street 1:807 W MARKET ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-2625
Practice Address - Country:US
Practice Address - Phone:502-585-3534
Practice Address - Fax:502-585-3539
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1097103T00000X, 103TF0200X, 103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
Not Answered103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service