Provider Demographics
NPI:1508885294
Name:MORRISON, SHARON LA'TISE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:LA'TISE
Last Name:MORRISON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6015 KENNEDY BLVD E
Mailing Address - Street 2:APT. B6
Mailing Address - City:WEST NEW YORK
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-3735
Mailing Address - Country:US
Mailing Address - Phone:201-854-6262
Mailing Address - Fax:
Practice Address - Street 1:423 E 23RD ST
Practice Address - Street 2:SWS- 122, ROOM 2578A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5011
Practice Address - Country:US
Practice Address - Phone:212-686-7500
Practice Address - Fax:212-951-6309
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0500781041C0700X
NJ44SC0506890001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ44SC05068900OtherLICENSED CLINICAL SOCIAL
NYR050078OtherLICENSED CLINICAL SOCIAL