Provider Demographics
NPI:1366035875
Name:LAKEWOOD PSYCHOLOGICAL SERVICES P.C.
Entity Type:Organization
Organization Name:LAKEWOOD PSYCHOLOGICAL SERVICES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:816-516-4039
Mailing Address - Street 1:709 NE LA COSTA ST
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64064-1359
Mailing Address - Country:US
Mailing Address - Phone:816-516-4039
Mailing Address - Fax:
Practice Address - Street 1:709 NE LA COSTA ST
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064-1359
Practice Address - Country:US
Practice Address - Phone:816-516-4039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty