Provider Demographics
NPI:1831372960
Name:NORTON, SUSAN (MS LPC)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:NORTON
Suffix:
Gender:F
Credentials:MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-12
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43726300Medicaid