Provider Demographics
NPI:1568476620
Name:MORTON, DOUGLAS PAUL (MS, LPC)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:PAUL
Last Name:MORTON
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2963
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:AK
Mailing Address - Zip Code:99603-2963
Mailing Address - Country:US
Mailing Address - Phone:907-235-3932
Mailing Address - Fax:907-235-0638
Practice Address - Street 1:4060 HEATH ST
Practice Address - Street 2:HOMER POLICE DEPARTMENT
Practice Address - City:HOMER
Practice Address - State:AK
Practice Address - Zip Code:99603-7609
Practice Address - Country:US
Practice Address - Phone:907-235-3932
Practice Address - Fax:907-235-0638
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK159101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional