Provider Demographics
NPI:1154423796
Name:MORTON, ELIZABETH SUSAN (MSW)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:SUSAN
Last Name:MORTON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-2708
Mailing Address - Country:US
Mailing Address - Phone:860-889-0097
Mailing Address - Fax:860-889-3184
Practice Address - Street 1:119 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-2708
Practice Address - Country:US
Practice Address - Phone:860-889-0097
Practice Address - Fax:860-889-3184
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0029731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical