Provider Demographics
NPI:1689711855
Name:MORRISON, LARRY DARNELL
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:DARNELL
Last Name:MORRISON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 DACHSHUND DR
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-9115
Mailing Address - Country:US
Mailing Address - Phone:910-527-0175
Mailing Address - Fax:
Practice Address - Street 1:1609 SWEETGUM CIR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-2707
Practice Address - Country:US
Practice Address - Phone:910-867-3279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor