Provider Demographics
NPI:1427137975
Name:MORRIS, LOIS ANN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LOIS
Middle Name:ANN
Last Name:MORRIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LOIS
Other - Middle Name:ANN
Other - Last Name:DATZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5036 JERICHO TURNPIKE
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725
Mailing Address - Country:US
Mailing Address - Phone:631-462-5222
Mailing Address - Fax:631-462-5258
Practice Address - Street 1:5036 JERICHO TURNPIKE
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725
Practice Address - Country:US
Practice Address - Phone:631-462-5222
Practice Address - Fax:631-462-5258
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0224521104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN6G021Medicare ID - Type Unspecified