Provider Demographics
NPI:1437792496
Name:MORRIS, JACQUELINE (LGPC)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:
Other - Last Name:WINDMUELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7954 COBBLER LN
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-2049
Mailing Address - Country:US
Mailing Address - Phone:443-891-4512
Mailing Address - Fax:
Practice Address - Street 1:7310 RITCHIE HWY STE 1009
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-3398
Practice Address - Country:US
Practice Address - Phone:410-768-5988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP9549101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional