Healthcare Provider Details

I. General information

NPI: 1083766117
Provider Name (Legal Business Name): PRISCILLA A MORTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4131 SPICEWOOD SPRINGS ROAD M 2
AUSTIN TX
78759
US

IV. Provider business mailing address

4131 SPICEWOOD SPRINGS ROAD M 2
AUSTIN TX
78759
US

V. Phone/Fax

Practice location:
  • Phone: 512-340-9294
  • Fax: 512-342-2931
Mailing address:
  • Phone: 512-340-9294
  • Fax: 512-342-2931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number41877
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: