Provider Demographics
NPI:1366658874
Name:MORRISON, MICHAEL A (MA)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:MORRISON
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:759 CLUB CIR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-3236
Mailing Address - Country:US
Mailing Address - Phone:303-886-7367
Mailing Address - Fax:
Practice Address - Street 1:1900 13TH ST
Practice Address - Street 2:SUITE 305
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5240
Practice Address - Country:US
Practice Address - Phone:303-886-7367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1769101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional