Provider Demographics
NPI:1730108051
Name:MORRISON, MARILYN KAY (MA, MED, LPC)
Entity Type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:KAY
Last Name:MORRISON
Suffix:
Gender:F
Credentials:MA, MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1018 N GLOSTER ST STE D
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38804-1234
Mailing Address - Country:US
Mailing Address - Phone:662-844-1804
Mailing Address - Fax:662-844-1668
Practice Address - Street 1:1018 N GLOSTER ST STE D
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-1234
Practice Address - Country:US
Practice Address - Phone:662-844-1804
Practice Address - Fax:662-844-1668
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0442101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health