Basic Information
Provider Information
NPI: 1467071845
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORTON
FirstName: ALLISON
MiddleName: R
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 985450 NEBRASKA MEDICAL CTR
Address2:  
City: OMAHA
State: NE
PostalCode: 681985450
CountryCode: US
TelephoneNumber: 4025596408
FaxNumber: 4025595737
Practice Location
Address1: 6902 PINE ST
Address2:  
City: OMAHA
State: NE
PostalCode: 681062855
CountryCode: US
TelephoneNumber: 4025596408
FaxNumber: 4025595737
Other Information
ProviderEnumerationDate: 04/15/2020
LastUpdateDate: 10/27/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/27/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103T00000X1108NEY Behavioral Health & Social Service ProvidersPsychologist 

No ID Information.


Home