Provider Demographics
NPI:1881815470
Name:NORRIS, DAN D (PSY D)
Entity Type:Individual
Prefix:
First Name:DAN
Middle Name:D
Last Name:NORRIS
Suffix:
Gender:M
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 W WINGOHOCKING ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-1306
Mailing Address - Country:US
Mailing Address - Phone:215-292-3162
Mailing Address - Fax:
Practice Address - Street 1:3156 KENSINGTON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-2400
Practice Address - Country:US
Practice Address - Phone:215-831-1100
Practice Address - Fax:215-807-8951
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005850L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA241954F5ZOtherMEDICARE PART B