Healthcare Provider Details

I. General information

NPI: 1376550723
Provider Name (Legal Business Name): DEBRA DEBOLT MORRIS LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 03/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 OLD SOLOMONS ISLAND RD
ANNAPOLIS MD
21401-3845
US

IV. Provider business mailing address

1334 ANGLESEY DR
DAVIDSONVILLE MD
21035-1264
US

V. Phone/Fax

Practice location:
  • Phone: 410-266-8345
  • Fax: 410-266-6278
Mailing address:
  • Phone: 410-956-0980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11271
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: