Healthcare Provider Details

I. General information

NPI: 1053152595
Provider Name (Legal Business Name): TYLER LINDSAY MORRIS MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2024
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8101 SANDY SPRING RD
LAUREL MD
20707-3596
US

IV. Provider business mailing address

9181 VANGUARD LN APT 303
FREDERICK MD
21704-7479
US

V. Phone/Fax

Practice location:
  • Phone: 800-994-5403
  • Fax:
Mailing address:
  • Phone: 802-689-2809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number31460
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: