Healthcare Provider Details

I. General information

NPI: 1407516214
Provider Name (Legal Business Name): ELIZABETH MORRIS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2021
Last Update Date: 12/20/2021
Certification Date: 12/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 5TH ST STE 100
SANTA FE NM
87505-5403
US

IV. Provider business mailing address

265 EL DUANE CT
SANTA FE NM
87501-1179
US

V. Phone/Fax

Practice location:
  • Phone: 505-927-8026
  • Fax:
Mailing address:
  • Phone: 617-631-7949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12207
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: