Healthcare Provider Details

I. General information

NPI: 1831891654
Provider Name (Legal Business Name): VICTORIA LYNN NORRIS LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2023
Last Update Date: 03/28/2023
Certification Date: 03/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

547 PINEWAY DR
MARTINSBURG WV
25405-5573
US

IV. Provider business mailing address

547 PINEWAY DR
MARTINSBURG WV
25405-5573
US

V. Phone/Fax

Practice location:
  • Phone: 304-839-4379
  • Fax:
Mailing address:
  • Phone: 304-839-4379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC12014
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC12014
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: