MEDICARE: JARED D. MORRISON CSW

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	LCSW-24551	ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12261220	OTHER	ID	CAQH PIN
2	LCSW-24551	OTHER	ID	PROFESSIONAL LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407872377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JARED D. MORRISON CSW

Provider Business Mailing Address
First Line	:	1 KALISA WAY
Second Line	:	STE 101
City	:	PARAMUS
State	:	NJ
Zip	:	07652-3508
Country	:	US
Telephone Number	:	888-948-6789
Fax Number	:	877-345-3501

Provider Business Practice Location Address
First Line	:	840 E ELVA ST
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83401-2801
Country	:	US
Telephone Number	:	208-523-4795
Fax Number	:

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

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	07/28/2022

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