Provider Demographics
NPI:1447346424
Name:NORMAN, MARLEEN ELSIE (LCSW)
Entity type:Individual
Prefix:MS
First Name:MARLEEN
Middle Name:ELSIE
Last Name:NORMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 PRAGUE STREET
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-2851
Mailing Address - Country:US
Mailing Address - Phone:415-333-1655
Mailing Address - Fax:415-452-9602
Practice Address - Street 1:363 PRAGUE STREET
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112-2851
Practice Address - Country:US
Practice Address - Phone:415-333-1655
Practice Address - Fax:415-452-9602
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS39941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACSW039940OtherMEDI CAL CROSS OVER CLAIM
CAZZZ14147ZMedicare ID - Type Unspecified