Provider Demographics
NPI:1669965836
Name:MACREADY, NORRA (LMFT)
Entity type:Individual
Prefix:
First Name:NORRA
Middle Name:
Last Name:MACREADY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14600 DICKENS ST UNIT 101
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-3651
Mailing Address - Country:US
Mailing Address - Phone:818-528-2037
Mailing Address - Fax:
Practice Address - Street 1:16461 SHERMAN WAY STE 275
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-3825
Practice Address - Country:US
Practice Address - Phone:424-372-7827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-12
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA105049106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist