Provider Demographics
NPI:1003991639
Name:MORRISON, NICOLE S (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:S
Last Name:MORRISON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 MARKET XING
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-7841
Mailing Address - Country:US
Mailing Address - Phone:781-361-5711
Mailing Address - Fax:508-224-2550
Practice Address - Street 1:3 MARKET XING
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-7841
Practice Address - Country:US
Practice Address - Phone:781-361-5711
Practice Address - Fax:508-224-2550
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1120121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical