Provider Demographics
NPI:1467988709
Name:MORRIS, MORGAN
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 N VAN BUREN RD
Mailing Address - Street 2:
Mailing Address - City:LONE JACK
Mailing Address - State:MO
Mailing Address - Zip Code:64070-9404
Mailing Address - Country:US
Mailing Address - Phone:707-208-5031
Mailing Address - Fax:
Practice Address - Street 1:106 N VAN BUREN RD
Practice Address - Street 2:
Practice Address - City:LONE JACK
Practice Address - State:MO
Practice Address - Zip Code:64070-9404
Practice Address - Country:US
Practice Address - Phone:707-208-5031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-05
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS10041104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker