Provider Demographics
NPI:1942421268
Name:MORRISON, MARY CATHARINE (MS)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:CATHARINE
Last Name:MORRISON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:CATHARINE
Other - Last Name:HAZZARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS LCPC
Mailing Address - Street 1:333 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-3113
Mailing Address - Country:US
Mailing Address - Phone:207-282-3373
Mailing Address - Fax:
Practice Address - Street 1:333 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-3113
Practice Address - Country:US
Practice Address - Phone:207-282-3373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC1728101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
279881OtherMANAGED HEALTH NETWORK
9160261OtherPHCS
040988OtherANTHEM BCBS
2007627OtherCIGNA
114193OtherTEAMSTERS
162418OtherVALUE OPTIONS