Healthcare Provider Details

I. General information

NPI: 1477242568
Provider Name (Legal Business Name): CHRISTINA NORTON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2023
Last Update Date: 05/03/2023
Certification Date: 05/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1770 FENWICK DR
COMMERCE TOWNSHIP MI
48382-1493
US

IV. Provider business mailing address

1770 FENWICK DR
COMMERCE TOWNSHIP MI
48382-1493
US

V. Phone/Fax

Practice location:
  • Phone: 734-646-3050
  • Fax:
Mailing address:
  • Phone: 734-646-3050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA NORTON
Title or Position: OWNER
Credential: LPC
Phone: 734-646-3050