Healthcare Provider Details

I. General information

NPI: 1497436190
Provider Name (Legal Business Name): MARIA MORRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2023
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 SPRATT ST STE B
FORT MILL SC
29715-4111
US

IV. Provider business mailing address

421 HARRIS ST
FORT MILL SC
29715-2117
US

V. Phone/Fax

Practice location:
  • Phone: 704-931-1010
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8690
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: