Provider Demographics
NPI:1750653861
Name:MORRISSEY, LUKE T (EDS, LPC)
Entity Type:Individual
Prefix:MR
First Name:LUKE
Middle Name:T
Last Name:MORRISSEY
Suffix:
Gender:M
Credentials:EDS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:448 TYSONS FOREST DR
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-3805
Mailing Address - Country:US
Mailing Address - Phone:803-727-3437
Mailing Address - Fax:
Practice Address - Street 1:2025 EBENEZER RD
Practice Address - Street 2:SUITE M1
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1062
Practice Address - Country:US
Practice Address - Phone:803-727-3437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-04
Last Update Date:2013-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA8467101YP2500X
SC5465101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional