Provider Demographics
NPI:1740979889
Name:MORRISON, MICHELLE P
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:P
Last Name:MORRISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4N141 NORTON LAKE DR
Mailing Address - Street 2:
Mailing Address - City:CAMPTON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60175-6843
Mailing Address - Country:US
Mailing Address - Phone:630-673-1140
Mailing Address - Fax:
Practice Address - Street 1:4N141 NORTON LAKE DR
Practice Address - Street 2:
Practice Address - City:CAMPTON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60175-6843
Practice Address - Country:US
Practice Address - Phone:630-673-1140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-04
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL152001118103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst