Provider Demographics
NPI:1952124562
Name:MORRISON, ORRIN-PORTER (MA, PHD)
Entity type:Individual
Prefix:DR
First Name:ORRIN-PORTER
Middle Name:
Last Name:MORRISON
Suffix:
Gender:M
Credentials:MA, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 W PAXTON AVE UNIT 241
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84101-3261
Mailing Address - Country:US
Mailing Address - Phone:385-299-8841
Mailing Address - Fax:
Practice Address - Street 1:264 E 12200 S STE G
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-7861
Practice Address - Country:US
Practice Address - Phone:385-299-8841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-02
Last Update Date:2024-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14018408-2501103TC1900X, 103TP2701X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy