Provider Demographics
NPI:1770984478
Name:CATHERINE M. MORRELL, PSYD., LICENSED CLINICAL PSYCHOLOGIST, LLC
Entity type:Organization
Organization Name:CATHERINE M. MORRELL, PSYD., LICENSED CLINICAL PSYCHOLOGIST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:MORRELL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:860-888-5489
Mailing Address - Street 1:PO BOX 206
Mailing Address - Street 2:891 MAIN STREET OFFICE C
Mailing Address - City:SOUTH GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06073-0206
Mailing Address - Country:US
Mailing Address - Phone:860-430-1882
Mailing Address - Fax:
Practice Address - Street 1:891 MAIN STREET
Practice Address - Street 2:
Practice Address - City:SOUTH GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06073
Practice Address - Country:US
Practice Address - Phone:860-430-1882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-12
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003378103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty