Provider Demographics
NPI:1104134683
Name:NORRIS, STEPHANY ANN (LPC)
Entity type:Individual
Prefix:
First Name:STEPHANY
Middle Name:ANN
Last Name:NORRIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 N PATTERSON ST
Mailing Address - Street 2:SUITE G
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-2568
Mailing Address - Country:US
Mailing Address - Phone:229-244-9688
Mailing Address - Fax:229-244-5354
Practice Address - Street 1:2310 N PATTERSON ST
Practice Address - Street 2:SUITE G
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-2568
Practice Address - Country:US
Practice Address - Phone:229-244-9688
Practice Address - Fax:229-244-5354
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-18
Last Update Date:2010-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006116101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional