Healthcare Provider Details

I. General information

NPI: 1821864729
Provider Name (Legal Business Name): ELIZABETH MORRILL LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LILY MORRILL

II. Dates (important events)

Enumeration Date: 11/30/2023
Last Update Date: 11/30/2023
Certification Date: 11/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 LENA ST STE C26
SANTA FE NM
87505-4340
US

IV. Provider business mailing address

2012 VALLE RIO ST
SANTA FE NM
87505-6127
US

V. Phone/Fax

Practice location:
  • Phone: 603-828-8563
  • Fax:
Mailing address:
  • Phone: 603-828-8563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCCMH0219711
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: