Healthcare Provider Details

I. General information

NPI: 1356061410
Provider Name (Legal Business Name): MADDISON R NORTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2022
Last Update Date: 03/07/2023
Certification Date: 03/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 MILL ST
BELMONT MA
02478-1048
US

IV. Provider business mailing address

115 MILL ST
BELMONT MA
02478-1064
US

V. Phone/Fax

Practice location:
  • Phone: 617-855-2207
  • Fax: 617-855-3724
Mailing address:
  • Phone: 617-855-2207
  • Fax: 617-855-3724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: