Provider Demographics
NPI:1245299056
Name:MORRISON, ANTHONY CARL (PHD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:CARL
Last Name:MORRISON
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 1:709 NE LACOSTA STREET
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64064-2499
Mailing Address - Country:US
Mailing Address - Phone:816-516-4039
Mailing Address - Fax:
Practice Address - Street 1:2237 S 600 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84106-1429
Practice Address - Country:US
Practice Address - Phone:801-483-2447
Practice Address - Fax:801-486-8705
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT973493072501103G00000X, 103T00000X, 103TF0000X, 103TH0100X, 103TR0400X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT005782601Medicare ID - Type Unspecified