Provider Demographics
NPI:1740533470
Name:MORRIS, ALVIN DEMETRIUS
Entity type:Individual
Prefix:
First Name:ALVIN
Middle Name:DEMETRIUS
Last Name:MORRIS
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 1:123 BLUE LEDGE DR
Mailing Address - Street 2:
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131-4813
Mailing Address - Country:US
Mailing Address - Phone:857-869-5798
Mailing Address - Fax:
Practice Address - Street 1:123 BLUE LEDGE DR
Practice Address - Street 2:
Practice Address - City:ROSLINDALE
Practice Address - State:MA
Practice Address - Zip Code:02131-4813
Practice Address - Country:US
Practice Address - Phone:857-869-5798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor