Healthcare Provider Details

I. General information

NPI: 1831762483
Provider Name (Legal Business Name): ELZETTER MARIA NORRIS NCC, LCMHC, LCAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2021
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

168 BLAIR DR
LUMBERTON NC
28360-1798
US

IV. Provider business mailing address

168 BLAIR DR
LUMBERTON NC
28360-1798
US

V. Phone/Fax

Practice location:
  • Phone: 910-785-2556
  • Fax: 866-427-5310
Mailing address:
  • Phone: 910-785-2556
  • Fax: 866-427-5310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number16677
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: