MEDICARE: CAROLYN MORRIS LCSW-SASD

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
2	1041C0700X	Clinical Social Worker	2005025411	MO
3	1041C0700X	Clinical Social Worker	7374	WI

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	:	1811188964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLYN MORRIS LCSW-SASD

Provider Business Mailing Address
First Line	:	10425 W NORTH AVE STE 311
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53226-2400
Country	:	US
Telephone Number	:	414-436-9188
Fax Number	:

Provider Business Practice Location Address
First Line	:	10425 W NORTH AVE STE 311
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53226-2400
Country	:	US
Telephone Number	:	414-436-9918
Fax Number	:

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

Provider Enumeration Date	:	08/05/2007
Last Update Date	:	06/28/2023

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Directions to “ CAROLYN MORRIS LCSW-SASD” Practice Location

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