Healthcare Provider Details
I. General information
NPI: 1700897329
Provider Name (Legal Business Name): AIMEE WILSON MORRIS LPC, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/10/2006
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5604 OLD BULLARD RD STE 108
TYLER TX
75703-4359
US
IV. Provider business mailing address
5604 OLD BULLARD RD STE 108
TYLER TX
75703-4359
US
V. Phone/Fax
- Phone: 903-939-2287
- Fax: 903-939-2938
- Phone: 903-939-2287
- Fax: 903-939-2938
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | 04677 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 13460 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: