Provider Demographics
NPI:1629957709
Name:NORRIS, DESHANA BRENEE (LCMHCA)
Entity type:Individual
Prefix:
First Name:DESHANA
Middle Name:BRENEE
Last Name:NORRIS
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3615 AZALEA RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOLLY
Mailing Address - State:NC
Mailing Address - Zip Code:28120-1301
Mailing Address - Country:US
Mailing Address - Phone:704-649-6824
Mailing Address - Fax:704-649-6824
Practice Address - Street 1:3615 AZALEA RIDGE DR
Practice Address - Street 2:
Practice Address - City:MOUNT HOLLY
Practice Address - State:NC
Practice Address - Zip Code:28120-1301
Practice Address - Country:US
Practice Address - Phone:704-649-6824
Practice Address - Fax:704-649-6824
Is Sole Proprietor?:No
Enumeration Date:2025-09-02
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA21916101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health