Provider Demographics
NPI:1134150733
Name:MORRISON, JENNIFER A (LCSW)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:A
Last Name:MORRISON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:A
Other - Last Name:CRISMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:102 CHESTNUT STREET
Mailing Address - Street 2:
Mailing Address - City:PORT ALLEGANY
Mailing Address - State:PA
Mailing Address - Zip Code:16743
Mailing Address - Country:US
Mailing Address - Phone:814-642-9333
Mailing Address - Fax:814-642-9333
Practice Address - Street 1:10 CHURCH ST.
Practice Address - Street 2:
Practice Address - City:PORT ALLEGANY
Practice Address - State:PA
Practice Address - Zip Code:16743
Practice Address - Country:US
Practice Address - Phone:814-558-1820
Practice Address - Fax:814-642-9333
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0149771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA264069OtherCOMPSYCH
PA2255431OtherCIGNA
MO090619OtherMEDICARE ID TYPE UNSPECIFIED
PA2255431OtherCIGNA