Healthcare Provider Details

I. General information

NPI: 1821912460
Provider Name (Legal Business Name): SHAMIRAH T MORRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

634 CLINTON AVENUE APT 209
NEWARK NJ
07108
US

IV. Provider business mailing address

634 CLINTON AVENUE APT 209
NEWARK NJ
07108
US

V. Phone/Fax

Practice location:
  • Phone: 973-382-3765
  • Fax:
Mailing address:
  • Phone: 973-382-3765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number26NR26215400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: