Provider Demographics
NPI:1700897329
Name:MORRIS, AIMEE WILSON (LPC, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:WILSON
Last Name:MORRIS
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:MISS
Other - First Name:AIMEE
Other - Middle Name:GEORGINA
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7524 S BROADWAY AVE
Mailing Address - Street 2:SUITE 117
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-5007
Mailing Address - Country:US
Mailing Address - Phone:903-939-2287
Mailing Address - Fax:903-939-2938
Practice Address - Street 1:7524 S BROADWAY AVE
Practice Address - Street 2:SUITE 117
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-5007
Practice Address - Country:US
Practice Address - Phone:903-939-2287
Practice Address - Fax:903-939-2938
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13460101YP2500X
TX004677106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX82327LOtherBLUE CROSS/BLUE SHIELD
579155OtherVALUE OPTIONS
TXLP 8002074OtherNHIC