Healthcare Provider Details

I. General information

NPI: 1073980397
Provider Name (Legal Business Name): MORRISON COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2015
Last Update Date: 08/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 LAKE MICHIGAN DR NW SUITE C
GRAND RAPIDS MI
49534-7815
US

IV. Provider business mailing address

1726 CAMBRIDGE DR SE
GRAND RAPIDS MI
49506-4424
US

V. Phone/Fax

Practice location:
  • Phone: 616-536-7116
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ELLEN MORRISON
Title or Position: THERAPIST
Credential: LMSW, IMH-E(II)
Phone: 616-516-9895