Individual provider Active NPI

Willie Bryon Norris, LPC-A

  • Mental Health Counselor
  • Selma, NC
National Provider Identifier
1497270722
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
13194 Issued in NC
Practice address
1420A S Pollock St
Selma, NC 27576-3404
Phone
(919) 351-0428
Fax
(919) 351-0814
NPI assigned
Aug 8, 2017
Last updated
Jan 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X A13194 NC
Mental Health Counselor 101YM0800X 13194 NC Primary

Addresses

Primary practice location

1420A S Pollock St
Selma, NC 27576-3404

Mailing address

1420A S Pollock St
Selma, NC 27576-3404
Phone (919) 351-0428

Other practice location 1

3106 S Memorial Dr Ste B
Greenville, NC 27834-6765
Phone (252) 916-6048

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250410002595 NC Practitioner - Mental Health Counselor 8123542149 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13194NCMDMental Health Counselor
A13194NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Yotaron Enrichment Resource Center CurrentSince Jan 27, 2025 Accepting new patients
Pathways to Life, Inc PastSince Jul 24, 2022 Accepting new patients

Locations

3106 S Memorial Dr
Ste B
Greenville, NC 27834
Phone (252) 916-6048

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1502150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1497270722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420A S POLLOCK ST",
            "city": "SELMA",
            "state": "NC",
            "postal_code": "275763404",
            "telephone_number": "919-351-0428",
            "fax_number": "919-351-0814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420A S POLLOCK ST",
            "city": "SELMA",
            "state": "NC",
            "postal_code": "275763404",
            "telephone_number": "919-351-0428",
            "fax_number": "919-351-0814"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3106 S Memorial Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278346765",
            "country_code": "US",
            "telephone_number": "252-916-6048",
            "fax_number": "252-371-1655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NORRIS",
        "first_name": "WILLIE",
        "middle_name": "BRYON",
        "credential": "LPC-A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-08",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A13194",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "13194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Selma, NC

Sources for this page

Verify at the official NPI Registry.