Provider Demographics
NPI:1447491188
Name:MORRIS, KATHRYN R (LICSW)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:R
Last Name:MORRIS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:R
Other - Last Name:GARTLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:707 SHERIDAN AVE
Mailing Address - Street 2:
Mailing Address - City:CODY
Mailing Address - State:WY
Mailing Address - Zip Code:82414-3409
Mailing Address - Country:US
Mailing Address - Phone:307-527-7501
Mailing Address - Fax:
Practice Address - Street 1:424 YELLOWSTONE AVE STE 220
Practice Address - Street 2:
Practice Address - City:CODY
Practice Address - State:WY
Practice Address - Zip Code:82414
Practice Address - Country:US
Practice Address - Phone:307-578-2287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-10
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVDP009411481041C0700X
WY1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical