Provider Demographics
NPI:1114341690
Name:MORRISON, KENT (MA, LAADC-R, CADC II)
Entity Type:Individual
Prefix:
First Name:KENT
Middle Name:
Last Name:MORRISON
Suffix:
Gender:M
Credentials:MA, LAADC-R, CADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7996 OLD WINDING WAY STE 300
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-7159
Mailing Address - Country:US
Mailing Address - Phone:916-966-4523
Mailing Address - Fax:916-966-4599
Practice Address - Street 1:7996 OLD WINDING WAY STE 300
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-7159
Practice Address - Country:US
Practice Address - Phone:916-966-4523
Practice Address - Fax:916-966-4599
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALR140311101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)