Provider Demographics
NPI:1609521566
Name:MORRISON, JAKAYLA MONIQUE (LCSW)
Entity type:Individual
Prefix:
First Name:JAKAYLA
Middle Name:MONIQUE
Last Name:MORRISON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6201 DAYBROOK CIR APT 308
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-4075
Mailing Address - Country:US
Mailing Address - Phone:704-914-8919
Mailing Address - Fax:
Practice Address - Street 1:5000 FALLS OF NEUSE RD STE 300
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-5480
Practice Address - Country:US
Practice Address - Phone:919-865-8710
Practice Address - Fax:919-784-9184
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-18
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC015461104100000X, 1041C0700X
NCP0151301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker