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NPI Code Detail

MEDICARE: JOANNA MARIE MORRISSEY MS, BCBA

MEDICARE: JOANNA MARIE MORRISSEY MS, BCBA
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
1103K00000XBehavior Analyst1-17-26768IL

General Provider Information

NPI Number : 1790208957
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOANNA MARIE MORRISSEY MS, BCBA
Provider Business Mailing Address
First Line : 5220 6TH STREET FRONTAGE RD E STE 1700
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62703-5771
Country : US
Telephone Number : 217-525-8332
Fax Number : 217-525-1420
Provider Business Practice Location Address
First Line : 5220 6TH STREET FRONTAGE RD E STE 1700
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62703-5771
Country : US
Telephone Number : 217-525-8332
Fax Number : 217-525-1420
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2017
Last Update Date : 07/21/2022

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