Provider Demographics
NPI:1366525420
Name:MORRISSETT, JOHN THURMAN (MS, LPC)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:THURMAN
Last Name:MORRISSETT
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:305 WEST BESSEMER AVE.
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1405
Mailing Address - Country:US
Mailing Address - Phone:336-339-4003
Mailing Address - Fax:919-663-0424
Practice Address - Street 1:106 VILLAGE LAKE RD
Practice Address - Street 2:
Practice Address - City:SILER CITY
Practice Address - State:NC
Practice Address - Zip Code:27344-1821
Practice Address - Country:US
Practice Address - Phone:336-339-4003
Practice Address - Fax:919-663-0424
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLPC 3334101Y00000X
NC3334101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103197Medicaid