Provider Demographics
NPI:1760702054
Name:MORRISSETTE, VONDA L (LPC)
Entity Type:Individual
Prefix:
First Name:VONDA
Middle Name:L
Last Name:MORRISSETTE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 SUMMITRIDGE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35757-8601
Mailing Address - Country:US
Mailing Address - Phone:256-701-0780
Mailing Address - Fax:
Practice Address - Street 1:149 MAGNUM LN
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-9421
Practice Address - Country:US
Practice Address - Phone:256-701-0780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-09
Last Update Date:2011-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64125101YP2500X
AL2984101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional