Provider Demographics
NPI:1578735577
Name:MCMORRIS COUNSELING & CONSULTING, INC,
Entity Type:Organization
Organization Name:MCMORRIS COUNSELING & CONSULTING, INC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:LAVERN
Authorized Official - Last Name:MCMORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:402-208-3047
Mailing Address - Street 1:2505 N 24TH ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68110-2252
Mailing Address - Country:US
Mailing Address - Phone:402-208-3047
Mailing Address - Fax:
Practice Address - Street 1:2505 N 24TH ST
Practice Address - Street 2:SUITE 220
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68110-2252
Practice Address - Country:US
Practice Address - Phone:402-208-3047
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7618101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025613300Medicaid