Provider Demographics
NPI:1982748489
Name:MORSE, ANDREA S (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:S
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 1:400 LAKE COOK RD STE 221
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-4930
Mailing Address - Country:US
Mailing Address - Phone:773-450-2530
Mailing Address - Fax:773-481-9428
Practice Address - Street 1:400 LAKE COOK RD STE 221
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-4930
Practice Address - Country:US
Practice Address - Phone:773-450-2530
Practice Address - Fax:773-481-9428
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04932234OtherBLUE CROSS BLUE SHIELD IL
IL04932234OtherBLUE CROSS BLUE SHIELD IL