Provider Demographics
NPI:1891120630
Name:NORRIS, KERRY (RSW)
Entity Type:Individual
Prefix:MS
First Name:KERRY
Middle Name:
Last Name:NORRIS
Suffix:
Gender:F
Credentials:RSW
Other - Prefix:MS
Other - First Name:KERRY
Other - Middle Name:
Other - Last Name:KURT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RSW
Mailing Address - Street 1:417 S JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2237
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:417 S JOHNSON ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2237
Practice Address - Country:US
Practice Address - Phone:504-524-7205
Practice Address - Fax:504-581-4702
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-12
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11283104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker