Provider Demographics
NPI:1639633266
Name:MORGAN, LARISSA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LARISSA
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2107 LAUREL BUSH RD STE 206
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-5203
Mailing Address - Country:US
Mailing Address - Phone:443-619-3891
Mailing Address - Fax:
Practice Address - Street 1:2107 LAUREL BUSH RD STE 206
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-5203
Practice Address - Country:US
Practice Address - Phone:443-619-3891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-28
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05678103T00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist