Provider Demographics
NPI:1912918392
Name:MORSE, NESHA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:NESHA
Middle Name:
Last Name:MORSE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 MARQUEZ PL
Mailing Address - Street 2:211 A
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-1834
Mailing Address - Country:US
Mailing Address - Phone:505-424-4547
Mailing Address - Fax:505-982-2196
Practice Address - Street 1:1012 MARQUEZ PL
Practice Address - Street 2:211 A
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-1834
Practice Address - Country:US
Practice Address - Phone:505-424-4547
Practice Address - Fax:505-982-2196
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0787103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM000Z4776Medicaid