Provider Demographics
NPI:1114052537
Name:MORRIS, SUZANNE M (LCSW, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:M
Last Name:MORRIS
Suffix:
Gender:F
Credentials:LCSW, LMFT
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 9090
Mailing Address - Street 2:
Mailing Address - City:MICHIGAN CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46361-9090
Mailing Address - Country:US
Mailing Address - Phone:219-879-3283
Mailing Address - Fax:219-879-6965
Practice Address - Street 1:340 COMMERCE SQ
Practice Address - Street 2:
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-3288
Practice Address - Country:US
Practice Address - Phone:219-879-3283
Practice Address - Fax:219-879-6965
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34002951A101YM0800X
IN35000020A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000218539OtherBCBS
IN489610BMedicare ID - Type Unspecified