Healthcare Provider Details

I. General information

NPI: 1588872204
Provider Name (Legal Business Name): JOSEPH MORRIS-WILLIAM EADER LPC, LCMHC, NCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 05/24/2022
Certification Date: 05/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3435 HICKORY NECK BLVD
TOANO VA
23168-8732
US

IV. Provider business mailing address

3435 HICKORY NECK BLVD
TOANO VA
23168-8732
US

V. Phone/Fax

Practice location:
  • Phone: 757-940-5009
  • Fax:
Mailing address:
  • Phone: 757-940-5009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701007576
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5365
License Number StateSC
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number11611
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: