Provider Demographics
NPI:1568875516
Name:MORRIS, TODD C
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:C
Last Name:MORRIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1191 TORREYS CT
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41011-1122
Mailing Address - Country:US
Mailing Address - Phone:513-602-3030
Mailing Address - Fax:
Practice Address - Street 1:1191 TORREYS CT
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:KY
Practice Address - Zip Code:41011-1122
Practice Address - Country:US
Practice Address - Phone:513-602-3030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-07
Last Update Date:2014-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHICDC.981029-CS101YA0400X
KY0503101YA0400X
OHS.0600906104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)