Provider Demographics
NPI:1952810301
Name:NORBY, CONSTANCE JEAN (LPC, MSB, NCC)
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:JEAN
Last Name:NORBY
Suffix:
Gender:F
Credentials:LPC, MSB, NCC
Other - Prefix:
Other - First Name:CONSTANCE
Other - Middle Name:JEAN
Other - Last Name:MCCARTHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:E 9021 STATE RD 96
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:WI
Mailing Address - Zip Code:54940
Mailing Address - Country:US
Mailing Address - Phone:920-787-7472
Mailing Address - Fax:920-787-5458
Practice Address - Street 1:225 N MAIN ST STE 3
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:WI
Practice Address - Zip Code:54165-1309
Practice Address - Country:US
Practice Address - Phone:920-385-1420
Practice Address - Fax:866-327-3259
Is Sole Proprietor?:No
Enumeration Date:2017-09-28
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI18328-130101YA0400X
WI2764-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)