Provider Demographics
NPI:1124258652
Name:NORTON, SKYE TRINITY (MA)
Entity type:Individual
Prefix:MRS
First Name:SKYE
Middle Name:TRINITY
Last Name:NORTON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 36219
Mailing Address - Street 2:YUCCA LODGE
Mailing Address - City:FORT BAYARD
Mailing Address - State:NM
Mailing Address - Zip Code:88036-6219
Mailing Address - Country:US
Mailing Address - Phone:575-537-8824
Mailing Address - Fax:575-537-3760
Practice Address - Street 1:149 CAMINO DEL CIELO
Practice Address - Street 2:YUCCA LODGE
Practice Address - City:FORT BAYARD
Practice Address - State:NM
Practice Address - Zip Code:88036
Practice Address - Country:US
Practice Address - Phone:575-537-8824
Practice Address - Fax:575-537-3760
Is Sole Proprietor?:No
Enumeration Date:2009-07-17
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0107061101YA0400X
NM0123441101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health