Provider Demographics
NPI:1366229841
Name:NORRIS, LATRISA LAURY (LCSWA)
Entity type:Individual
Prefix:
First Name:LATRISA
Middle Name:LAURY
Last Name:NORRIS
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14316 REESE BLVD W # B-837
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-7959
Mailing Address - Country:US
Mailing Address - Phone:704-292-0216
Mailing Address - Fax:
Practice Address - Street 1:1121 OLD CONCORD RD STE 5
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28146-1473
Practice Address - Country:US
Practice Address - Phone:980-202-3084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-11
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty