Provider Demographics
NPI:1699555136
Name:MORELOCK, JACI ELIZABETH
Entity type:Individual
Prefix:
First Name:JACI
Middle Name:ELIZABETH
Last Name:MORELOCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 HEMPHILL CT
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033-6560
Mailing Address - Country:US
Mailing Address - Phone:940-445-7024
Mailing Address - Fax:
Practice Address - Street 1:212 N ANGLIN ST
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76031-4133
Practice Address - Country:US
Practice Address - Phone:940-445-7024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85235101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health