Provider Demographics
NPI:1114598240
Name:MORRIS, ARDRACE D
Entity Type:Individual
Prefix:MR
First Name:ARDRACE
Middle Name:D
Last Name:MORRIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6650 AVALON DR SE
Mailing Address - Street 2:
Mailing Address - City:CALEDONIA
Mailing Address - State:MI
Mailing Address - Zip Code:49316-7970
Mailing Address - Country:US
Mailing Address - Phone:616-914-3535
Mailing Address - Fax:
Practice Address - Street 1:550 CASCADE WEST PKWY SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-2137
Practice Address - Country:US
Practice Address - Phone:616-930-4123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling