Provider Demographics
NPI:1932325180
Name:NORRIS, LANETIA MARIE (LMSW, ACSW)
Entity Type:Individual
Prefix:MRS
First Name:LANETIA
Middle Name:MARIE
Last Name:NORRIS
Suffix:
Gender:F
Credentials:LMSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20592 WOODBINE ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219-4512
Mailing Address - Country:US
Mailing Address - Phone:313-207-8000
Mailing Address - Fax:313-354-8426
Practice Address - Street 1:20700 CIVIC CENTER DR
Practice Address - Street 2:SUITE 170
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-4140
Practice Address - Country:US
Practice Address - Phone:313-207-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical