Provider Demographics
NPI:1972510360
Name:NORTON, CYNTHIA J (LCSW MSW)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:J
Last Name:NORTON
Suffix:
Gender:F
Credentials:LCSW MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 S MULFORD RD
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61108-3011
Mailing Address - Country:US
Mailing Address - Phone:815-399-5700
Mailing Address - Fax:815-399-5767
Practice Address - Street 1:415 S MULFORD RD
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61108-3011
Practice Address - Country:US
Practice Address - Phone:815-399-5700
Practice Address - Fax:815-399-5767
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490100001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL208913Medicare UPIN