Provider Demographics
NPI:1821864729
Name:MORRILL, ELIZABETH (LPCC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:MORRILL
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:LILY
Other - Middle Name:
Other - Last Name:MORRILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2012 VALLE RIO ST
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-6127
Mailing Address - Country:US
Mailing Address - Phone:603-828-8563
Mailing Address - Fax:
Practice Address - Street 1:1600 LENA ST STE C26
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4340
Practice Address - Country:US
Practice Address - Phone:603-828-8563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCCMH0219711101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional