Provider Demographics
NPI:1215645874
Name:NORTON, JUSTIN F
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:F
Last Name:NORTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5040 BOB BILLINGS PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-3843
Mailing Address - Country:US
Mailing Address - Phone:913-585-5979
Mailing Address - Fax:
Practice Address - Street 1:5040 BOB BILLINGS PKWY STE B
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-3843
Practice Address - Country:US
Practice Address - Phone:913-585-5979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-11
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04830101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health