Provider Demographics
NPI:1366576019
Name:MORRIS, KATHY LYNN (MSSW)
Entity type:Individual
Prefix:MS
First Name:KATHY
Middle Name:LYNN
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3741 RUTLEDGE RD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-5566
Mailing Address - Country:US
Mailing Address - Phone:505-798-9300
Mailing Address - Fax:505-798-0808
Practice Address - Street 1:3741 RUTLEDGE RD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-5566
Practice Address - Country:US
Practice Address - Phone:505-798-9300
Practice Address - Fax:505-798-0808
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM62770705Medicaid