Provider Demographics
NPI:1376138875
Name:MORSE, JOAN MARIE (MFT)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:MARIE
Last Name:MORSE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:M
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1023 KING AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46222-3636
Mailing Address - Country:US
Mailing Address - Phone:317-965-4708
Mailing Address - Fax:
Practice Address - Street 1:1144 W 30TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46208-4929
Practice Address - Country:US
Practice Address - Phone:317-969-5694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health