Provider Demographics
NPI:1487683850
Name:MORRIS, ANDREA LEE (CSW)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:LEE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2519 TYLER AVE
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84401-2818
Mailing Address - Country:US
Mailing Address - Phone:801-393-2019
Mailing Address - Fax:801-584-2544
Practice Address - Street 1:500 FOOTHILL BLVD
Practice Address - Street 2:BLD 47
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84148-0001
Practice Address - Country:US
Practice Address - Phone:800-613-4012
Practice Address - Fax:801-584-2544
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6089765-3502104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker