Provider Demographics
NPI:1013288224
Name:MORRIS, MAXWELL JAMES (BS)
Entity Type:Individual
Prefix:
First Name:MAXWELL
Middle Name:JAMES
Last Name:MORRIS
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:MAXWELL
Other - Middle Name:JAMES
Other - Last Name:EWING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1601 OLIVE ST APT 906
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-3979
Mailing Address - Country:US
Mailing Address - Phone:541-327-4514
Mailing Address - Fax:
Practice Address - Street 1:1255 PEARL ST STE 102
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3570
Practice Address - Country:US
Practice Address - Phone:541-687-6983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
OR1013288224103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health