Provider Demographics
NPI:1801133244
Name:MORRIS, JEANNINE FITCH (LCSW, ACSW)
Entity type:Individual
Prefix:MRS
First Name:JEANNINE
Middle Name:FITCH
Last Name:MORRIS
Suffix:
Gender:F
Credentials:LCSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 SANDAGER AVE
Mailing Address - Street 2:
Mailing Address - City:JEANERETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70544-6008
Mailing Address - Country:US
Mailing Address - Phone:337-339-0051
Mailing Address - Fax:
Practice Address - Street 1:105 MARIE ST
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70563-2425
Practice Address - Country:US
Practice Address - Phone:337-339-0051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-04
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA36371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA600809400Medicaid