Provider Demographics
NPI:1417909276
Name:MORRISON, LINDA L (PHD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:L
Last Name:MORRISON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 PORTLAND RD
Mailing Address - Street 2:SUITE 42
Mailing Address - City:KENNEBUNK
Mailing Address - State:ME
Mailing Address - Zip Code:04043-6658
Mailing Address - Country:US
Mailing Address - Phone:207-468-9472
Mailing Address - Fax:888-765-8406
Practice Address - Street 1:62 PORTLAND RD
Practice Address - Street 2:SUITE 42
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043-6658
Practice Address - Country:US
Practice Address - Phone:207-468-9472
Practice Address - Fax:888-765-8406
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPS951103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME251794000OtherMAGELLAN
ME223110000Medicaid
ME7540335OtherAETNA
ME025766OtherANTHEM
ME251794000OtherMAGELLAN