Provider Demographics
NPI:1043109143
Name:MORRIS, NATHAN II
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:MORRIS
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 748465
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-8465
Mailing Address - Country:US
Mailing Address - Phone:855-284-7483
Mailing Address - Fax:617-807-0958
Practice Address - Street 1:2700 WETSHALL LANE
Practice Address - Street 2:SUITE 118
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-7451
Practice Address - Country:US
Practice Address - Phone:239-999-1029
Practice Address - Fax:617-807-0958
Is Sole Proprietor?:No
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH27331101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health