Provider Demographics
NPI:1093211781
Name:MORRISSEY, TODD MATTHEW II (MA)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:MATTHEW
Last Name:MORRISSEY
Suffix:II
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1518 NE 117TH ST APT 301
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-5155
Mailing Address - Country:US
Mailing Address - Phone:630-667-4695
Mailing Address - Fax:
Practice Address - Street 1:18 W MERCER ST STE 380
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119-3965
Practice Address - Country:US
Practice Address - Phone:206-929-3989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60775267101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health