MEDICARE: MICHELLE M MARIE MORRISSEY LPC, NCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LPC.0013807	CO

General Provider Information

NPI Number	:	1184141772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE M MARIE MORRISSEY LPC, NCC

Provider Business Mailing Address
First Line	:	1325 N CASCADE AVE APT 1
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-2305
Country	:	US
Telephone Number	:	719-313-2011
Fax Number	:

Provider Business Practice Location Address
First Line	:	627 N WEBER ST STE 9
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-5008
Country	:	US
Telephone Number	:	719-313-2011
Fax Number	:	719-313-2011

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2017
Last Update Date	:	10/24/2018

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