Provider Demographics
NPI:1417224312
Name:MORRIS, SHANNON E (LMHC)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:E
Last Name:MORRIS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:E
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCPC
Mailing Address - Street 1:39 CARVER BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-3504
Mailing Address - Country:US
Mailing Address - Phone:508-243-6322
Mailing Address - Fax:
Practice Address - Street 1:39 CARVER BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-3504
Practice Address - Country:US
Practice Address - Phone:508-243-6322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-20
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7840101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health