Provider Demographics
NPI:1598476970
Name:MORRIS, HEATHER KAY
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:KAY
Last Name:MORRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 HILLCREST AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33461-6042
Mailing Address - Country:US
Mailing Address - Phone:321-439-1497
Mailing Address - Fax:
Practice Address - Street 1:1820 HILLCREST AVE
Practice Address - Street 2:
Practice Address - City:LAKE WORTH BEACH
Practice Address - State:FL
Practice Address - Zip Code:33461-6042
Practice Address - Country:US
Practice Address - Phone:321-439-1497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21815101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor