Provider Demographics
NPI:1043712524
Name:MORISON, LENA CLAIRE (LCMHCA, MT-BC, LPMT)
Entity type:Individual
Prefix:
First Name:LENA
Middle Name:CLAIRE
Last Name:MORISON
Suffix:
Gender:F
Credentials:LCMHCA, MT-BC, LPMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 S HAWTHORNE RD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-3784
Mailing Address - Country:US
Mailing Address - Phone:336-716-0855
Mailing Address - Fax:
Practice Address - Street 1:100 KIMEL FOREST DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-6074
Practice Address - Country:US
Practice Address - Phone:367-160-8553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-01
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA19212101YP2500X
101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional