Healthcare Provider Details

I. General information

NPI: 1083779672
Provider Name (Legal Business Name): CHRISTOPHER STEPHEN MORSE MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 HOULTON RD
PRESQUE ISLE ME
04769-5207
US

IV. Provider business mailing address

PO BOX 1429 19 HOULTON RD
PRESQUE ISLE ME
04769-1429
US

V. Phone/Fax

Practice location:
  • Phone: 207-764-3071
  • Fax: 207-764-3659
Mailing address:
  • Phone: 207-764-3071
  • Fax: 207-764-3659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC5595
License Number StateME

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: