Provider Demographics
NPI:1730456732
Name:MORRIS, BETSY MARIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:BETSY
Middle Name:MARIE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2792
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97339-2792
Mailing Address - Country:US
Mailing Address - Phone:541-768-5254
Mailing Address - Fax:541-768-5257
Practice Address - Street 1:749 SW 11TH STREET
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:OR
Practice Address - Zip Code:97365
Practice Address - Country:US
Practice Address - Phone:541-574-1811
Practice Address - Fax:541-574-3383
Is Sole Proprietor?:No
Enumeration Date:2011-11-19
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL36901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORL3690OtherSTATE LICENSE NUMBER