Provider Demographics
NPI:1902234263
Name:MORLEY, THOMAS RUSSELL (AMFT)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:RUSSELL
Last Name:MORLEY
Suffix:
Gender:M
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2794 HIDDEN SPRINGS CIR # 15A
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-3221
Mailing Address - Country:US
Mailing Address - Phone:385-218-1971
Mailing Address - Fax:
Practice Address - Street 1:8765 GREEN VALLEY ROAD
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-3105
Practice Address - Country:US
Practice Address - Phone:530-622-5551
Practice Address - Fax:530-622-5800
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-24
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT117321106H00000X
CA117321106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist