Provider Demographics
NPI:1871702993
Name:NORTON, KIMBERLY A (PHD)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:NORTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 GREEN AVE
Mailing Address - Street 2:
Mailing Address - City:NEW CANAAN
Mailing Address - State:CT
Mailing Address - Zip Code:06840-5833
Mailing Address - Country:US
Mailing Address - Phone:917-860-1693
Mailing Address - Fax:
Practice Address - Street 1:17 GREEN AVE
Practice Address - Street 2:
Practice Address - City:NEW CANAAN
Practice Address - State:CT
Practice Address - Zip Code:06840-5833
Practice Address - Country:US
Practice Address - Phone:917-860-1693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012890-1103TC0700X
CT002415103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01711068Medicaid