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NPI Code Detail

MEDICARE: STACYLEE ANN MORRIS MA LADC CCS

MEDICARE: STACYLEE ANN MORRIS MA LADC CCS
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
1101YA0400XAddiction (Substance Use Disorder) Counselor3762ME

General Provider Information

NPI Number : 1992994727
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACYLEE ANN MORRIS MA LADC CCS
Provider Business Mailing Address
First Line : 4 PARK ST
Second Line :
City : LEWISTON
State : ME
Zip : 04240-7172
Country : US
Telephone Number : 207-784-0922
Fax Number :
Provider Business Practice Location Address
First Line : 4 PARK ST
Second Line :
City : LEWISTON
State : ME
Zip : 04240-7172
Country : US
Telephone Number : 207-784-0922
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2007
Last Update Date : 08/24/2009

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Directions to “ STACYLEE ANN MORRIS MA LADC CCS” Practice Location

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