Provider Demographics
NPI:1932116316
Name:MORRISON, TINA LORRAINE (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:TINA
Middle Name:LORRAINE
Last Name:MORRISON
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3117 COONEY DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59602-0248
Mailing Address - Country:US
Mailing Address - Phone:406-442-3869
Mailing Address - Fax:406-443-1965
Practice Address - Street 1:3117 COONEY DR
Practice Address - Street 2:SUITE 102
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59602-0248
Practice Address - Country:US
Practice Address - Phone:406-442-3869
Practice Address - Fax:406-443-1965
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT866101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT22281OtherMT DPHHS
MT0252229Medicaid
MT740353OtherBCBS