Provider Demographics
NPI:1396927422
Name:MORRISSEY, JOSEPH DEE
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:DEE
Last Name:MORRISSEY
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 1:8700 OSBORNE TPKE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23231-8104
Mailing Address - Country:US
Mailing Address - Phone:804-795-2249
Mailing Address - Fax:804-674-1688
Practice Address - Street 1:8700 OSBORNE TPKE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23231-8104
Practice Address - Country:US
Practice Address - Phone:804-795-2249
Practice Address - Fax:804-674-1688
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA524-01-001320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities