Individual provider Active NPI

Kenneth Dean Morris Jr.

  • Counselor
  • Glendale, AZ
National Provider Identifier
1447019286
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
17505 N 79TH Ave Ste 410
Glendale, AZ 85308-8732
Phone
(623) 800-7980
NPI assigned
Mar 14, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X AZ Primary

Addresses

Primary practice location

17505 N 79TH Ave Ste 410
Glendale, AZ 85308-8732

Mailing address

1970 N Hartford St Unit 81
Chandler, AZ 85225-7303
Phone (480) 773-2189

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Surge Points LLC Counselor CurrentSince Mar 17, 2024 Accepting new patients

Locations

17505 N 79th Ave
Ste 410
Glendale, AZ 85308
Phone (623) 800-7945

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1710374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1447019286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 N HARTFORD ST UNIT 81",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852257303",
            "telephone_number": "480-773-2189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17505 N 79TH AVE STE 410",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088732",
            "telephone_number": "623-800-7980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "KENNETH",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-14",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.