Provider Demographics
NPI:1053635169
Name:NORTON PSYCHOLOGICAL SERVICES LLC
Entity type:Organization
Organization Name:NORTON PSYCHOLOGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:R
Authorized Official - Last Name:NORTON
Authorized Official - Suffix:
Authorized Official - Credentials:MS LCPC NCC
Authorized Official - Phone:224-406-1474
Mailing Address - Street 1:128 NEWBERRY AVE
Mailing Address - Street 2:SUITE 8
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-1923
Mailing Address - Country:US
Mailing Address - Phone:224-406-1474
Mailing Address - Fax:224-513-4641
Practice Address - Street 1:128 NEWBERRY AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-1923
Practice Address - Country:US
Practice Address - Phone:224-406-1474
Practice Address - Fax:224-513-4641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180006616101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1306044706OtherLICENSED CLINICAL PROFESSIONAL COUNSELOR