Provider Demographics
NPI:1760108799
Name:NORTON, KAITLYN (PLPC)
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:
Last Name:NORTON
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 553
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39158-0553
Mailing Address - Country:US
Mailing Address - Phone:601-941-6043
Mailing Address - Fax:
Practice Address - Street 1:930 EBENEZER BLVD STE D
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-6079
Practice Address - Country:US
Practice Address - Phone:601-340-8022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-12
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSP-0663101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional