Healthcare Provider Details

I. General information

NPI: 1134150733
Provider Name (Legal Business Name): JENNIFER A MORRISON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. JENNIFER A CRISMAN

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 12/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CHURCH ST.
PORT ALLEGANY PA
16743
US

IV. Provider business mailing address

102 CHESTNUT STREET
PORT ALLEGANY PA
16743
US

V. Phone/Fax

Practice location:
  • Phone: 814-558-1820
  • Fax: 814-642-9333
Mailing address:
  • Phone: 814-642-9333
  • Fax: 814-642-9333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW014977
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier264069
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerCOMPSYCH
# 2
Identifier2255431
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerCIGNA
# 3
IdentifierMO090619
Identifier TypeOTHER
Identifier State
Identifier IssuerMEDICARE ID TYPE UNSPECIFIED

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: