Organization
PENELOPE L. NORTON, PHD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BECKY MOREY (OFFICE MANAGER)
(386) 676-5420
Entity
Organization
Contact information
Practice address
555 W GRANADA BLVD STE E3, ORMOND BEACH, FL 32174-9401
(386) 676-5420
Mailing address
555 W GRANADA BLVD STE E3, ORMOND BEACH, FL 32174-9401
(386) 676-5420
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY0003198
FL
103TC2200X
Clinical Child & Adolescent Psychologist
PY0003198
FL
103TP2701X
Group Psychotherapy Psychologist
PY0003198
FL
106H00000X
Marriage & Family Therapist
PY0003198
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
75607
BCBS
FL
Enumeration date
04/05/2016
Last updated
04/05/2016
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