Provider Demographics
NPI:1073839502
Name:MORRIS, ELAINE MARIE (LMHC, CAP)
Entity Type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:MARIE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:LMHC, CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:885 SW 173RD AVE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-4218
Mailing Address - Country:US
Mailing Address - Phone:954-804-6119
Mailing Address - Fax:954-435-2626
Practice Address - Street 1:8910 MIRAMAR PKWY
Practice Address - Street 2:SUITE 204
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-4100
Practice Address - Country:US
Practice Address - Phone:954-804-6119
Practice Address - Fax:954-435-2626
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-08
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4776101YA0400X
FLMH8058101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)