Provider Demographics
NPI:1104504646
Name:NORRIS, ANTHONY C (LMSW)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:C
Last Name:NORRIS
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5634 W SUGAR PINE DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65802-7813
Mailing Address - Country:US
Mailing Address - Phone:417-849-5395
Mailing Address - Fax:
Practice Address - Street 1:5634 W SUGAR PINE DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65802-7813
Practice Address - Country:US
Practice Address - Phone:417-849-5395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-06
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20250097541041C0700X
MO2020036116104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty