Provider Demographics
NPI:1114110087
Name:MORRIS, DANA LYNN (PSS)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:LYNN
Last Name:MORRIS
Suffix:
Gender:F
Credentials:PSS
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:LYNN
Other - Last Name:BURCKEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSS
Mailing Address - Street 1:687 CHESHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-5060
Mailing Address - Country:US
Mailing Address - Phone:541-343-2993
Mailing Address - Fax:541-343-2338
Practice Address - Street 1:687 CHESHIRE AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-5060
Practice Address - Country:US
Practice Address - Phone:541-343-2993
Practice Address - Fax:541-343-2338
Is Sole Proprietor?:No
Enumeration Date:2007-08-23
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT-20-223101YA0400X
175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR101YA0400XMedicaid
OR175T00000XMedicaid