Provider Demographics
NPI:1588011159
Name:MORRISON, JAMIE ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:ANN
Last Name:MORRISON
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 1:2001 83RD AVE N LOT 5066
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-3919
Mailing Address - Country:US
Mailing Address - Phone:781-971-2209
Mailing Address - Fax:
Practice Address - Street 1:301 BROADWAY
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-2807
Practice Address - Country:US
Practice Address - Phone:617-912-7914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-24
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
FLSW162281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker