Provider Demographics
NPI:1720154719
Name:DUPREE, NORRIS D JR (MFT, PSYCH, LADC)
Entity Type:Individual
Prefix:MR
First Name:NORRIS
Middle Name:D
Last Name:DUPREE
Suffix:JR
Gender:M
Credentials:MFT, PSYCH, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 ODDIE BLVD
Mailing Address - Street 2:B
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-1269
Mailing Address - Country:US
Mailing Address - Phone:775-359-9200
Mailing Address - Fax:775-359-9205
Practice Address - Street 1:1555 ODDIE BLVD
Practice Address - Street 2:B
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-1269
Practice Address - Country:US
Practice Address - Phone:775-359-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01081106H00000X
NV0000076723103TS0200X
NV1085101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1720154719Medicaid