Provider Demographics
NPI:1700501301
Name:MORRIS, MONIQUE S (LMSW-CLINICAL)
Entity Type:Individual
Prefix:MS
First Name:MONIQUE
Middle Name:S
Last Name:MORRIS
Suffix:
Gender:F
Credentials:LMSW-CLINICAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 ANDREWS AVE
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-1265
Mailing Address - Country:US
Mailing Address - Phone:609-870-3432
Mailing Address - Fax:
Practice Address - Street 1:403 ROUTE 70 E STE 201
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2417
Practice Address - Country:US
Practice Address - Phone:856-395-9566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05692200104100000X
PASW137541104100000X
MI68011004081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker