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General NPI Number Information
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NPI Number | 1003453416
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Entity Type | Individual
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Provider Name | CHANTANIQUE MORRISON LMHC
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Gender | Female
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Dates
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Enumeration Date | 12/04/2019
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Last Update Date | 01/02/2020
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Provider Practice Location Address
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Address Line | 1441 BROADWAY FL 5
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City | NEW YORK
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State | NY
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Zip | 10018-1905
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Country | US
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Telephone | 914-893-0062
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Fax |
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Provider Business Mailing Address
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Address Line | 1590 MADISON AVE APT 4H
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City | NEW YORK
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State | NY
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Zip | 10029-3869
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Country | US
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Telephone | 917-547-0651
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 009740-01
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License Number State | NY
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