Healthcare Provider Details

I. General information

NPI: 1639010655
Provider Name (Legal Business Name): MS. TANISHA RENEE MORRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1414 S GREEN RD STE 301
SOUTH EUCLID OH
44121-3937
US

IV. Provider business mailing address

1414 S GREEN RD STE 301
SOUTH EUCLID OH
44121-3937
US

V. Phone/Fax

Practice location:
  • Phone: 216-810-5397
  • Fax:
Mailing address:
  • Phone: 216-849-5388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: