Provider Demographics
NPI:1942807623
Name:MORRILL, TINA MARIE (LCMHC)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:MARIE
Last Name:MORRILL
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:TINA
Other - Middle Name:
Other - Last Name:GALLANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:271 DERRY RD
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03052-2708
Mailing Address - Country:US
Mailing Address - Phone:603-338-1586
Mailing Address - Fax:
Practice Address - Street 1:271 DERRY RD
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:NH
Practice Address - Zip Code:03052-2708
Practice Address - Country:US
Practice Address - Phone:603-338-1586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health