Healthcare Provider Details

I. General information

NPI: 1235557430
Provider Name (Legal Business Name): ANDREA NORTON-PACKER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DREA NORTON-PACKER LMSW

II. Dates (important events)

Enumeration Date: 04/03/2014
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4713 OAKRIDGE DR
MIDLAND MI
48640-7409
US

IV. Provider business mailing address

4713 OAKRIDGE DR
MIDLAND MI
48640-7409
US

V. Phone/Fax

Practice location:
  • Phone: 517-899-2589
  • Fax:
Mailing address:
  • Phone: 517-899-2589
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801096054
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: