Provider Demographics
NPI:1205579919
Name:MORRIS, CHEYENNE (APSW)
Entity type:Individual
Prefix:
First Name:CHEYENNE
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:APSW
Other - Prefix:
Other - First Name:CHEYENNE
Other - Middle Name:
Other - Last Name:FITZGERALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APSW
Mailing Address - Street 1:6715 FAIRHAVEN RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-6220
Mailing Address - Country:US
Mailing Address - Phone:815-922-4255
Mailing Address - Fax:
Practice Address - Street 1:301 S BLOUNT ST STE 103
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-4664
Practice Address - Country:US
Practice Address - Phone:608-405-5111
Practice Address - Fax:608-554-1052
Is Sole Proprietor?:No
Enumeration Date:2022-04-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI131880-121104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker