Provider Demographics
NPI:1750977872
Name:MORRIS, ENCHELLE RENEE (LCPC)
Entity type:Individual
Prefix:
First Name:ENCHELLE
Middle Name:RENEE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 175TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-2039
Mailing Address - Country:US
Mailing Address - Phone:708-831-3943
Mailing Address - Fax:
Practice Address - Street 1:930 175TH ST
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-2039
Practice Address - Country:US
Practice Address - Phone:708-831-3943
Practice Address - Fax:312-584-4390
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-13
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL25434101YA0400X
IL30226101YA0400X
IL180013399101YP2500X, 101YM0800X
IL178012270101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional