Provider Demographics
NPI:1811129471
Name:CLASSEN, NORMA LEE (MA, LCPC)
Entity type:Individual
Prefix:MRS
First Name:NORMA
Middle Name:LEE
Last Name:CLASSEN
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:MISS
Other - First Name:NORMA
Other - Middle Name:LEE
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:3 CARLOCK DR
Mailing Address - Street 2:
Mailing Address - City:DANFORTH
Mailing Address - State:IL
Mailing Address - Zip Code:60930-6106
Mailing Address - Country:US
Mailing Address - Phone:815-861-9383
Mailing Address - Fax:
Practice Address - Street 1:701 DEVONSHIRE DRIVE
Practice Address - Street 2:C-22
Practice Address - City:CHAMPAINE
Practice Address - State:IL
Practice Address - Zip Code:61820
Practice Address - Country:US
Practice Address - Phone:815-861-9383
Practice Address - Fax:217-398-0413
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-17
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180006592101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health