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General NPI Number Information
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NPI Number | 1558743542
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Entity Type | Individual
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Provider Name | TIARRA CHARELLE MORRIS LCMHC, LCAS
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Gender | Female
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Dates
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Enumeration Date | 06/25/2015
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Last Update Date | 06/21/2023
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Provider Practice Location Address
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Address Line | 3209 ALLERTON CIRCLE E
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City | GREENSBORO
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State | NC
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Zip | 27409
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Country | US
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Telephone | 743-201-5834
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2420
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City | KERNERSVILLE
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State | NC
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Zip | 27285-2420
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Country | US
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Telephone | 743-201-5834
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 11705
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 21911
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License Number State | NC
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