Healthcare Provider Details

I. General information

NPI: 1083824510
Provider Name (Legal Business Name): JENNIFER MORRIS L.C.S.W.- C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1831 FOREST DR STE B
ANNAPOLIS MD
21401-4430
US

IV. Provider business mailing address

1831 FOREST DR STE B
ANNAPOLIS MD
21401-4430
US

V. Phone/Fax

Practice location:
  • Phone: 410-320-5157
  • Fax:
Mailing address:
  • Phone: 410-320-5157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number06693
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: