Healthcare Provider Details

I. General information

NPI: 1821328881
Provider Name (Legal Business Name): KATHLENE M MORSE LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2010
Last Update Date: 02/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4334 SECOR RD
TOLEDO OH
43623-4234
US

IV. Provider business mailing address

4334 SECOR RD
TOLEDO OH
43623-4234
US

V. Phone/Fax

Practice location:
  • Phone: 419-475-3635
  • Fax: 419-475-3635
Mailing address:
  • Phone: 419-475-3635
  • Fax: 419-475-3635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE1400301
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number6401006680
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: