Provider Demographics
NPI:1558532259
Name:MCMORRIS, BONITA THELMA (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:BONITA
Middle Name:THELMA
Last Name:MCMORRIS
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 1:8835 THORNTON GARDEN LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-5195
Mailing Address - Country:US
Mailing Address - Phone:919-876-9794
Mailing Address - Fax:252-559-2055
Practice Address - Street 1:8835 THORNTON GARDEN LN
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-5195
Practice Address - Country:US
Practice Address - Phone:919-876-9794
Practice Address - Fax:252-559-2055
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-20
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0059241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical