Healthcare Provider Details
I. General information
NPI: 1689963167
Provider Name (Legal Business Name): JANICE M MORRIS PHD PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/05/2011
Last Update Date: 05/02/2022
Certification Date: 05/02/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9501 N CAPITAL OF TEXAS HWY STE 305
AUSTIN TX
78759-6374
US
IV. Provider business mailing address
9501 N CAPITAL OF TEXAS HWY STE 305
AUSTIN TX
78759-6374
US
V. Phone/Fax
- Phone: 512-265-6848
- Fax: 866-314-1887
- Phone: 512-265-6848
- Fax: 866-314-1887
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 23266 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JANICE
M
MORRIS
Title or Position: OWNER
Credential: PHD
Phone: 512-265-6848