Provider Demographics
NPI:1962843094
Name:NORTON, MICHELLE MARIE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MARIE
Last Name:NORTON
Suffix:
Gender:F
Credentials:MA, LPC
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 3984
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-0040
Mailing Address - Country:US
Mailing Address - Phone:704-861-8405
Mailing Address - Fax:704-865-0590
Practice Address - Street 1:258 E GARRISON BLVD
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-0460
Practice Address - Country:US
Practice Address - Phone:704-861-8405
Practice Address - Fax:704-865-0590
Is Sole Proprietor?:No
Enumeration Date:2013-07-17
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA10270101YM0800X
NC10270101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC562279640Medicaid