Healthcare Provider Details

I. General information

NPI: 1487025094
Provider Name (Legal Business Name): NORKRIS SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2015
Last Update Date: 09/24/2024
Certification Date: 09/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 S UNION AVE
HAVRE DE GRACE MD
21078-3421
US

IV. Provider business mailing address

611 S UNION AVE
HAVRE DE GRACE MD
21078-3421
US

V. Phone/Fax

Practice location:
  • Phone: 443-526-6133
  • Fax: 443-526-6134
Mailing address:
  • Phone: 443-526-6133
  • Fax: 443-526-6134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR219171
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number
License Number StateNULL
# 6
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberAC001470
License Number StateMD

VIII. Authorized Official

Name: MS. AUDREY A FORKA
Title or Position: CEO
Credential: NP-C
Phone: 609-598-2298