Provider Demographics
NPI:1417281213
Name:PHINNESSEE, MORRIS JAMES (LPCMH)
Entity Type:Individual
Prefix:
First Name:MORRIS
Middle Name:JAMES
Last Name:PHINNESSEE
Suffix:
Gender:M
Credentials:LPCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 S GOVERNORS AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-7020
Mailing Address - Country:US
Mailing Address - Phone:302-678-4555
Mailing Address - Fax:302-678-4577
Practice Address - Street 1:1550 S GOVERNORS AVE
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-7020
Practice Address - Country:US
Practice Address - Phone:302-678-4555
Practice Address - Fax:302-678-4577
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-25
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000291101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health