=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699869834
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GARY JON NORTON MSW
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/03/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | CHILD AND FAMILY SERVICE OF PIONEER VALLEY 425 UNION STREET
-----------------------------------------------------
City | WEST SPRINGFIELD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01089
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 413-737-4718
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 45 GOLDEN HILL
-----------------------------------------------------
City | LEE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01238
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 413-243-0404
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 105370
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------