Provider Demographics
NPI:1740679919
Name:MORRIS, CRYSTAL NICOLE (LMSW)
Entity type:Individual
Prefix:MS
First Name:CRYSTAL
Middle Name:NICOLE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W 167TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-4201
Mailing Address - Country:US
Mailing Address - Phone:212-923-5950
Mailing Address - Fax:
Practice Address - Street 1:500 W 167TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-4201
Practice Address - Country:US
Practice Address - Phone:212-923-5950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0941091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical