Healthcare Provider Details

I. General information

NPI: 1285092932
Provider Name (Legal Business Name): HEATHER RENEE MORLATT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HEATHER R FAULKNER LCSW

II. Dates (important events)

Enumeration Date: 02/09/2016
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2480 BON HOMME RICHARD ST
JACKSONVILLE FL
32227
US

IV. Provider business mailing address

4558 FARMHOUSE GATE TRL
JACKSONVILLE FL
32226-2492
US

V. Phone/Fax

Practice location:
  • Phone: 904-270-5947
  • Fax:
Mailing address:
  • Phone: 315-406-5149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC011912
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09925794
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: