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General NPI Number Information
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NPI Number | 1750977872
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Entity Type | Individual
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Provider Name | ENCHELLE RENEE MORRIS LCPC
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Gender | Female
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Dates
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Enumeration Date | 12/13/2020
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Last Update Date | 10/06/2023
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Provider Practice Location Address
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Address Line | 930 175TH ST
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City | HOMEWOOD
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State | IL
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Zip | 60430-2039
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Country | US
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Telephone | 708-831-3943
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Fax | 312-584-4390
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Provider Business Mailing Address
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Address Line | 930 175TH ST
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City | HOMEWOOD
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State | IL
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Zip | 60430-2039
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Country | US
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Telephone | 708-831-3943
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 25434
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License Number State | IL
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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 | 30226
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180013399
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 178012270
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 180013399
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License Number State | IL
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