Provider Demographics
NPI:1720339195
Name:SUSAN NORTON
Entity Type:Organization
Organization Name:SUSAN NORTON
Other - Org Name:SUSAN NORTON, MS LPC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MS LPC
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-434-7457
Mailing Address - Street 1:2300 LINEVILLE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54313-8859
Mailing Address - Country:US
Mailing Address - Phone:920-434-7457
Mailing Address - Fax:920-434-7460
Practice Address - Street 1:2300 LINEVILLE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54313-8859
Practice Address - Country:US
Practice Address - Phone:920-434-7457
Practice Address - Fax:920-434-7460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-26
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4325125104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43726300Medicaid