Provider Demographics
NPI:1750051777
Name:MORRISON, MICHAEL TED (MS LMHC NCC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:TED
Last Name:MORRISON
Suffix:
Gender:M
Credentials:MS LMHC NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 7TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS JUNCTION
Mailing Address - State:IA
Mailing Address - Zip Code:52738-1008
Mailing Address - Country:US
Mailing Address - Phone:319-631-6110
Mailing Address - Fax:
Practice Address - Street 1:120 7TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS JUNCTION
Practice Address - State:IA
Practice Address - Zip Code:52738-1008
Practice Address - Country:US
Practice Address - Phone:319-631-6110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA098171101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional