Provider Demographics
NPI:1912233156
Name:MORRIS, CHARITY A (MA)
Entity Type:Individual
Prefix:
First Name:CHARITY
Middle Name:A
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 931
Mailing Address - Street 2:
Mailing Address - City:BAILEY
Mailing Address - State:CO
Mailing Address - Zip Code:80421-0931
Mailing Address - Country:US
Mailing Address - Phone:303-775-6791
Mailing Address - Fax:
Practice Address - Street 1:60615 SOUTH HWY 285
Practice Address - Street 2:
Practice Address - City:BAILEY
Practice Address - State:CO
Practice Address - Zip Code:80421
Practice Address - Country:US
Practice Address - Phone:303-775-6791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-22
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0458018101YS0200X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool