Healthcare Provider Details

I. General information

NPI: 1093150518
Provider Name (Legal Business Name): AARON BOND MORRIS L.M.H.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2013
Last Update Date: 12/13/2023
Certification Date: 12/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 RESERVOIR AVE APT C APT. C
MANVILLE RI
02838-1222
US

IV. Provider business mailing address

12 RESERVOIR AVE APT C APT. C
MANVILLE RI
02838-1222
US

V. Phone/Fax

Practice location:
  • Phone: 401-527-6212
  • Fax:
Mailing address:
  • Phone: 401-527-6212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC00704
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: