Provider Demographics
NPI:1396537064
Name:NORTON, CASEY (LLC)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:
Last Name:NORTON
Suffix:
Gender:F
Credentials:LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 MYERS LAKE AVE NE
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341-9626
Mailing Address - Country:US
Mailing Address - Phone:720-473-9887
Mailing Address - Fax:720-473-9887
Practice Address - Street 1:2215 29TH ST SE STE 8A
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49508-1565
Practice Address - Country:US
Practice Address - Phone:616-404-7004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451024322101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health