Provider Demographics
NPI:1396512620
Name:MORRISON, DOUGLAS A
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:A
Last Name:MORRISON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CHESTNUT ST APT 312
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07018-3828
Mailing Address - Country:US
Mailing Address - Phone:973-594-6853
Mailing Address - Fax:
Practice Address - Street 1:4 CHESTNUT ST APT 312
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-3828
Practice Address - Country:US
Practice Address - Phone:973-594-6853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00757000101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health