Healthcare Provider Details

I. General information

NPI: 1649426966
Provider Name (Legal Business Name): NORMAN HUFFMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: NORMAN HUFFMAN

II. Dates (important events)

Enumeration Date: 08/18/2008
Last Update Date: 09/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9650 SANTIAGO ROAD
COLUMBIA MD
21045
US

IV. Provider business mailing address

8466 CHURCH LANE ROAD
ELLICOTT CITY MD
21043
US

V. Phone/Fax

Practice location:
  • Phone: 360-903-4251
  • Fax:
Mailing address:
  • Phone: 360-903-4251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberT0739
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC2450
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLCM480
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number11-09-28
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: