Provider Demographics
NPI:1245532894
Name:MORRIS, TIA JENICE (MSW, ACSW, LCSW)
Entity type:Individual
Prefix:
First Name:TIA
Middle Name:JENICE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MSW, ACSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 N HIGHWAY 67
Mailing Address - Street 2:STE. #217
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63031-5904
Mailing Address - Country:US
Mailing Address - Phone:314-323-0463
Mailing Address - Fax:
Practice Address - Street 1:224 N HIGHWAY 67
Practice Address - Street 2:STE. #217
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63031-5904
Practice Address - Country:US
Practice Address - Phone:314-323-0463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20100369341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical