Provider Demographics
NPI:1366952780
Name:MORRIS, MYLINDA MARIE NUDD (LCSW, CSAC)
Entity type:Individual
Prefix:
First Name:MYLINDA
Middle Name:MARIE NUDD
Last Name:MORRIS
Suffix:
Gender:F
Credentials:LCSW, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-2129 KAIOLI ST APT 3304
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-6198
Mailing Address - Country:US
Mailing Address - Phone:910-489-7967
Mailing Address - Fax:
Practice Address - Street 1:91-2135 FORT WEAVER RD STE 501
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-1929
Practice Address - Country:US
Practice Address - Phone:808-312-6800
Practice Address - Fax:808-680-0003
Is Sole Proprietor?:No
Enumeration Date:2017-10-11
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040072901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical