Healthcare Provider Details

I. General information

NPI: 1154949527
Provider Name (Legal Business Name): PHILIP W MORRISON MA, LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2020
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 N KEENE ST
COLUMBIA MO
65201-6625
US

IV. Provider business mailing address

3401 BERRYWOOD DR
COLUMBIA MO
65201-8372
US

V. Phone/Fax

Practice location:
  • Phone: 573-874-8818
  • Fax:
Mailing address:
  • Phone: 573-777-8455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2020029277
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: