Healthcare Provider Details

I. General information

NPI: 1245446376
Provider Name (Legal Business Name): NANCY CAROL MORRISON PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 S LINCOLN AVE
O FALLON IL
62269-2665
US

IV. Provider business mailing address

625 WILDWOOD LN
O FALLON IL
62269-3105
US

V. Phone/Fax

Practice location:
  • Phone: 618-632-0701
  • Fax:
Mailing address:
  • Phone: 618-624-5964
  • Fax: 314-977-3214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number000313
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: