Healthcare Provider Details

I. General information

NPI: 1407279516
Provider Name (Legal Business Name): KERRI MORRIS PHD, BCBA-D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2014
Last Update Date: 09/17/2020
Certification Date: 09/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 FRANKLIN ST STE 5
WESTPORT CT
06880-5938
US

IV. Provider business mailing address

PO BOX 1071
WESTON CT
06883-0071
US

V. Phone/Fax

Practice location:
  • Phone: 203-895-6979
  • Fax:
Mailing address:
  • Phone: 203-895-6979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number#003364
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number#000489-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: