Provider Demographics
NPI:1689346819
Name:MORRISETT, LEAH RUTH (LPC-T)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:RUTH
Last Name:MORRISETT
Suffix:
Gender:F
Credentials:LPC-T
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:RUTH
Other - Last Name:SORENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC-T
Mailing Address - Street 1:1101 WHITE OAK RD
Mailing Address - Street 2:
Mailing Address - City:MC EWEN
Mailing Address - State:TN
Mailing Address - Zip Code:37101-5310
Mailing Address - Country:US
Mailing Address - Phone:336-937-1272
Mailing Address - Fax:
Practice Address - Street 1:1101 WHITE OAK RD
Practice Address - Street 2:
Practice Address - City:MC EWEN
Practice Address - State:TN
Practice Address - Zip Code:37101-5310
Practice Address - Country:US
Practice Address - Phone:336-937-1272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4924101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNAR159498OtherCPH & ASSOCIATES