Provider Demographics
NPI:1861577173
Name:MORRISON, JAY MERRILL (MSW)
Entity type:Individual
Prefix:MR
First Name:JAY
Middle Name:MERRILL
Last Name:MORRISON
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 SEAVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:MARBLEHEAD
Mailing Address - State:MA
Mailing Address - Zip Code:01945-1731
Mailing Address - Country:US
Mailing Address - Phone:781-631-0783
Mailing Address - Fax:
Practice Address - Street 1:83 CAMBRIDGE ST
Practice Address - Street 2:2-B
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-4181
Practice Address - Country:US
Practice Address - Phone:781-221-3180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA103600101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health