Provider Demographics
NPI:1447508858
Name:NORRIS, LYNDA M (MSW)
Entity type:Individual
Prefix:MRS
First Name:LYNDA
Middle Name:M
Last Name:NORRIS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VANDALIA
Mailing Address - State:IL
Mailing Address - Zip Code:62471-2214
Mailing Address - Country:US
Mailing Address - Phone:618-283-4229
Mailing Address - Fax:618-283-9203
Practice Address - Street 1:421 W MAIN ST
Practice Address - Street 2:
Practice Address - City:VANDALIA
Practice Address - State:IL
Practice Address - Zip Code:62471-2214
Practice Address - Country:US
Practice Address - Phone:618-283-4229
Practice Address - Fax:618-283-9203
Is Sole Proprietor?:No
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker