Provider Demographics
NPI:1225900095
Name:NORRIS, ELAINA R
Entity type:Individual
Prefix:
First Name:ELAINA
Middle Name:R
Last Name:NORRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2062 GRASMERE AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43211-2139
Mailing Address - Country:US
Mailing Address - Phone:614-208-4617
Mailing Address - Fax:614-792-6240
Practice Address - Street 1:3121 W BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-1306
Practice Address - Country:US
Practice Address - Phone:614-869-2002
Practice Address - Fax:614-792-6240
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.193675101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)