Healthcare Provider Details

I. General information

NPI: 1245299056
Provider Name (Legal Business Name): ANTHONY CARL MORRISON PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 03/04/2021
Certification Date: 02/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2237 S 600 E
SALT LAKE CITY UT
84106-1429
US

IV. Provider business mailing address

709 NE LACOSTA STREET
LEES SUMMIT MO
64064-2499
US

V. Phone/Fax

Practice location:
  • Phone: 801-483-2447
  • Fax: 801-486-8705
Mailing address:
  • Phone: 816-516-4039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number973493072501
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number973493072501
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number973493072501
License Number StateUT
# 4
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number973493072501
License Number StateUT
# 5
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number973493072501
License Number StateUT
# 6
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number973493072501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: