Provider Demographics
NPI:1780707000
Name:NORRIS, REBECCA DAWN (LCPC)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:DAWN
Last Name:NORRIS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16241 HARWOOD DR SW
Mailing Address - Street 2:
Mailing Address - City:FROSTBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21532-3528
Mailing Address - Country:US
Mailing Address - Phone:301-724-7277
Mailing Address - Fax:
Practice Address - Street 1:507 HENDERSON AVE
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-1562
Practice Address - Country:US
Practice Address - Phone:301-724-7277
Practice Address - Fax:301-724-7022
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1915101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD406970600Medicaid