Provider Demographics
NPI:1982020442
Name:MORRIS, JESSIE ELIZABETH (CSW)
Entity Type:Individual
Prefix:
First Name:JESSIE
Middle Name:ELIZABETH
Last Name:MORRIS
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 E 3900 S STE 200
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-2442
Mailing Address - Country:US
Mailing Address - Phone:801-313-0555
Mailing Address - Fax:
Practice Address - Street 1:740 E 3900 S STE 200
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-2442
Practice Address - Country:US
Practice Address - Phone:801-313-0555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-07
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5391619-3502104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker