Provider Demographics
NPI:1821343468
Name:JEFF MORRILL, LCSW, LLC
Entity Type:Organization
Organization Name:JEFF MORRILL, LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:MORRILL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:207-838-6843
Mailing Address - Street 1:PO BOX 1
Mailing Address - Street 2:
Mailing Address - City:TOPSHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04086-0001
Mailing Address - Country:US
Mailing Address - Phone:207-838-6843
Mailing Address - Fax:888-469-0843
Practice Address - Street 1:124 MAIN ST
Practice Address - Street 2:
Practice Address - City:TOPSHAM
Practice Address - State:ME
Practice Address - Zip Code:04086-1221
Practice Address - Country:US
Practice Address - Phone:207-838-6843
Practice Address - Fax:888-469-0843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC81741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty