Individual
MATTHEW P MORRISSETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
943 W. OVERLAND RD., STE 126, MERIDIAN, ID 83642-8600
(208) 926-2046
Mailing address
13601 W MCMILLAN RD STE 102-224, BOISE, ID 83713-2025
(208) 914-8080
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC-3444
ID
101YM0800X
Mental Health Counselor
LPC-2797
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010157489
REGENCE BLUE SHIELD
ID
01
—
Q7362
BLUE CROSS OF IDAHO
ID
Enumeration date
12/14/2006
Last updated
07/03/2023
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