Provider Demographics
NPI:1013002211
Name:MORRIS, JUDITH KOLB (MA, PHD, LICSW)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:KOLB
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MA, PHD, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 W. RODNEY FRENCH BLVD.
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02744
Mailing Address - Country:US
Mailing Address - Phone:508-984-5388
Mailing Address - Fax:
Practice Address - Street 1:50 N. SECOND ST.
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740
Practice Address - Country:US
Practice Address - Phone:508-993-1377
Practice Address - Fax:508-999-7795
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10260021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPO7452OtherBLUE CROSS BLUE SHIELD/MA