Provider Demographics
NPI:1568641975
Name:MORELOCK, IRENE CAROLYN (MS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:IRENE
Middle Name:CAROLYN
Last Name:MORELOCK
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:IRENE
Other - Middle Name:CAROLYN
Other - Last Name:BALDRIDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2144 E MONROE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65802-3052
Mailing Address - Country:US
Mailing Address - Phone:417-880-6914
Mailing Address - Fax:
Practice Address - Street 1:2200 E SUNSHINE ST
Practice Address - Street 2:SUITE 116
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-1819
Practice Address - Country:US
Practice Address - Phone:417-880-6914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005025542101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health