Provider Demographics
NPI:1548318314
Name:MORRISON, ORSON (PSYD)
Entity type:Individual
Prefix:MR
First Name:ORSON
Middle Name:
Last Name:MORRISON
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6645 NORTH AVE
Mailing Address - Street 2:UPPER LEVEL
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-1057
Mailing Address - Country:US
Mailing Address - Phone:708-386-5080
Mailing Address - Fax:708-386-5099
Practice Address - Street 1:6645 NORTH AVE
Practice Address - Street 2:UPPER LEVEL
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-1057
Practice Address - Country:US
Practice Address - Phone:708-386-5080
Practice Address - Fax:708-386-5099
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071006882103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical