MEDICARE: JONI MORRIS-ANDERSON LCSW

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	1041C0700X	Clinical Social Worker	SW 5806	FL

General Provider Information

NPI Number	:	1265461156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONI MORRIS-ANDERSON LCSW

Provider Business Mailing Address
First Line	:	5492 DENARGO DR
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32303-6739
Country	:	US
Telephone Number	:	850-922-2360
Fax Number	:

Provider Business Practice Location Address
First Line	:	10942 RECOVERY WAY
Second Line	:
City	:	WOODVILLE
State	:	FL
Zip	:	32362
Country	:	US
Telephone Number	:	850-922-2360
Fax Number	:

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

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	07/08/2007

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