Provider Demographics
NPI:1154080620
Name:MORRIS, AMY L (MAC, CAADC)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:L
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MAC, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4248 TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-5060
Mailing Address - Country:US
Mailing Address - Phone:678-414-5900
Mailing Address - Fax:
Practice Address - Street 1:5345 CROSSROADS DR
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30102-2536
Practice Address - Country:US
Practice Address - Phone:678-391-5950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-13
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAC0277101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty