Provider Demographics
NPI:1922193531
Name:MORRIS, TINA MARIE (MS, CPC, LIMHP)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:MARIE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MS, CPC, LIMHP
Other - Prefix:
Other - First Name:TINA
Other - Middle Name:MARIE
Other - Last Name:LORENZEN-WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CPC, LMHP
Mailing Address - Street 1:906 E 25TH ST
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-4603
Mailing Address - Country:US
Mailing Address - Phone:308-236-9105
Mailing Address - Fax:308-236-9903
Practice Address - Street 1:906 E 25TH ST
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-4603
Practice Address - Country:US
Practice Address - Phone:308-236-9105
Practice Address - Fax:308-236-9903
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1822101YP2500X, 101YM0800X
NE1218101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE732316000OtherMAGELLAN BEHAVIORAL HEALT
NE10025789800Medicaid
NE82360OtherBLUE CROSS BLUE SHIELD