Provider Demographics
NPI:1023124724
Name:EHRENBERG, MORRIS (PHD)
Entity type:Individual
Prefix:DR
First Name:MORRIS
Middle Name:
Last Name:EHRENBERG
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 WALKAWAY LN
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-5137
Mailing Address - Country:US
Mailing Address - Phone:856-778-7560
Mailing Address - Fax:856-857-0360
Practice Address - Street 1:3804 CHURCH RD
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-1106
Practice Address - Country:US
Practice Address - Phone:856-778-7560
Practice Address - Fax:856-857-0360
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00375500103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist