Provider Demographics
NPI:1831762483
Name:NORRIS, ELZETTER MARIA (NCC, LCMHC, LCAS)
Entity type:Individual
Prefix:
First Name:ELZETTER
Middle Name:MARIA
Last Name:NORRIS
Suffix:
Gender:F
Credentials:NCC, LCMHC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 BLAIR DR
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28360-1798
Mailing Address - Country:US
Mailing Address - Phone:910-785-2556
Mailing Address - Fax:866-427-5310
Practice Address - Street 1:707 UNION CHAPEL RD
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372-8689
Practice Address - Country:US
Practice Address - Phone:910-785-2556
Practice Address - Fax:866-427-5310
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-21
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16677101YP2500X, 101YM0800X
NCLCAS-27337101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health