Provider Demographics
NPI:1760935936
Name:MORRISON, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:MORRISON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 HANCOCK ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-5233
Mailing Address - Country:US
Mailing Address - Phone:617-774-0331
Mailing Address - Fax:617-774-0336
Practice Address - Street 1:1400 HANCOCK ST
Practice Address - Street 2:SUITE 2
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-5233
Practice Address - Country:US
Practice Address - Phone:617-774-0331
Practice Address - Fax:617-774-0336
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-25
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)