Healthcare Provider Details

I. General information

NPI: 1417984667
Provider Name (Legal Business Name): DANIEL VICTOR NORTON LCSWR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 07/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5820 MAIN ST STE. 308
WILLIAMSVILLE NY
14221-5776
US

IV. Provider business mailing address

28 HARBOUR POINTE CMN
BUFFALO NY
14202-4305
US

V. Phone/Fax

Practice location:
  • Phone: 716-812-1568
  • Fax:
Mailing address:
  • Phone: 716-812-1568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR030420
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: