MEDICARE: EBONY MORISH

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	101YM0800X	Mental Health Counselor	LPC013692	GA

General Provider Information

NPI Number	:	1942771100
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EBONY MORISH

Provider Business Mailing Address
First Line	:	9169 GARRETT LAKE DR
Second Line	:
City	:	MIDLAND
State	:	GA
Zip	:	31820-4391
Country	:	US
Telephone Number	:	706-536-5485
Fax Number	:

Provider Business Practice Location Address
First Line	:	2357 WARM SPRINGS RD STE 133
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-5692
Country	:	US
Telephone Number	:	334-787-9546
Fax Number	:

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

Provider Enumeration Date	:	12/16/2018
Last Update Date	:	03/25/2026

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Directions to “ EBONY MORISH ” Practice Location

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