Provider Demographics
NPI:1184141772
Name:MORRISSEY, MICHELLE M MARIE (LPC, NCC)
Entity type:Individual
Prefix:
First Name:MICHELLE M
Middle Name:MARIE
Last Name:MORRISSEY
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 N CASCADE AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-2305
Mailing Address - Country:US
Mailing Address - Phone:719-313-2011
Mailing Address - Fax:
Practice Address - Street 1:627 N WEBER ST STE 9
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-5008
Practice Address - Country:US
Practice Address - Phone:719-313-2011
Practice Address - Fax:719-313-2011
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-24
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0013807101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty