Provider Demographics
NPI:1740362185
Name:MORRISON, MICHAEL BRIEN (LCSW)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:BRIEN
Last Name:MORRISON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:
Other - Last Name:MORRISON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:295 WILLIAM AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10464
Mailing Address - Country:US
Mailing Address - Phone:718-885-9584
Mailing Address - Fax:718-885-9584
Practice Address - Street 1:24 EAST 12TH STREET
Practice Address - Street 2:SUITE 504A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-463-0244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028693-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN08831Medicare ID - Type Unspecified