Provider Demographics
NPI:1255670303
Name:MORRISON, BETH A (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:A
Last Name:MORRISON
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 GLOPEN RD
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62901-5860
Mailing Address - Country:US
Mailing Address - Phone:618-713-0597
Mailing Address - Fax:
Practice Address - Street 1:118 GLOPEN RD
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:IL
Practice Address - Zip Code:62901-5860
Practice Address - Country:US
Practice Address - Phone:618-713-0597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-10
Last Update Date:2013-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.008476101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional