Healthcare Provider Details
I. General information
NPI: 1780674077
Provider Name (Legal Business Name): WILLIAM G MORICE PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 10/26/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6100 N KEYSTONE AVE 528
INDIANAPOLIS IN
46220-2452
US
IV. Provider business mailing address
9503 E 86TH ST
INDIANAPOLIS IN
46256-9705
US
V. Phone/Fax
- Phone: 317-255-7228
- Fax:
- Phone: 317-255-7228
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 34002285A |
| License Number State | IN |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | 35000452A |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: