=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518381623
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EMILY MICHELLE MORRISON MA, LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/10/2014
-----------------------------------------------------
Last Update Date | 10/30/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1200 N WEST AVE
-----------------------------------------------------
City | JACKSON
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49202-2179
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 517-789-1209
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13714 E DIANE DR
-----------------------------------------------------
City | CAMDEN
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49232-9523
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 517-254-4556
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 6401011453
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------