MEDICARE: JESSICA L MORRIS LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	0904005122	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356414601
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA L MORRIS LCSW

Provider Business Mailing Address
First Line	:	3040 AVEMORE SQUARE PL
Second Line	:
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22911-7228
Country	:	US
Telephone Number	:	804-901-7911
Fax Number	:	804-672-7422

Provider Business Practice Location Address
First Line	:	4112 E PARHAM RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23228-2753
Country	:	US
Telephone Number	:	804-901-7911
Fax Number	:	804-672-7422

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	02/05/2020

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