Provider Demographics
NPI:1831506872
Name:MORRIS, STACEY MARIE (PMHNP)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:MARIE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:STACEY
Other - Middle Name:
Other - Last Name:LABONTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 95000 LBX 7650
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-0001
Mailing Address - Country:US
Mailing Address - Phone:207-777-8700
Mailing Address - Fax:
Practice Address - Street 1:100 CAMPUS AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-6040
Practice Address - Country:US
Practice Address - Phone:207-777-8974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-22
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP141069363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health