Provider Demographics
NPI:1295911840
Name:NORWOOD, WARREN KEITH (LPE)
Entity type:Individual
Prefix:
First Name:WARREN
Middle Name:KEITH
Last Name:NORWOOD
Suffix:
Gender:M
Credentials:LPE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3418 HAZELWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72015-6249
Mailing Address - Country:US
Mailing Address - Phone:501-317-8910
Mailing Address - Fax:870-772-5965
Practice Address - Street 1:3418 HAZELWOOD DR
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015-6249
Practice Address - Country:US
Practice Address - Phone:501-317-8910
Practice Address - Fax:870-772-5965
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR9305E103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist