Provider Demographics
NPI:1194078071
Name:LEWIS NORRIS, PAMELA L (LMHC, CAP, NCC)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:L
Last Name:LEWIS NORRIS
Suffix:
Gender:F
Credentials:LMHC, CAP, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 AURORA RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-5315
Mailing Address - Country:US
Mailing Address - Phone:321-242-1526
Mailing Address - Fax:321-242-7464
Practice Address - Street 1:1425 AURORA RD
Practice Address - Street 2:SUITE D
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-5315
Practice Address - Country:US
Practice Address - Phone:321-242-1526
Practice Address - Fax:321-242-7464
Is Sole Proprietor?:No
Enumeration Date:2012-10-17
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
53372101Y00000X
FL5303101YA0400X
FLMH 10739101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH 10739OtherLMHC
53372OtherNCC
FL5303OtherCAP