Provider Demographics
NPI:1154720001
Name:MORTON, MICHAEL (MS)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:MORTON
Suffix:
Gender:M
Credentials:MS
Other - Prefix:MR
Other - First Name:MICHAEL
Other - Middle Name:
Other - Last Name:MORTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:2014 GRANT ST APT 2
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33605-6332
Mailing Address - Country:US
Mailing Address - Phone:407-782-6414
Mailing Address - Fax:
Practice Address - Street 1:2014 GRANT ST APT 2
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33605-6332
Practice Address - Country:US
Practice Address - Phone:407-782-6414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-16
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMS, RMHCI 6713101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)