MEDICARE: MELISSA LYNNE MORGAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC1900X	Counseling Psychologist	071.007481	IL
2	103TC1900X	Counseling Psychologist	PSY24541	CA

General Provider Information

NPI Number	:	1073199543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA LYNNE MORGAN

Provider Business Mailing Address
First Line	:	136 E SOLA ST
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93101-1926
Country	:	US
Telephone Number	:	805-898-4018
Fax Number	:

Provider Business Practice Location Address
First Line	:	1225 COAST VILLAGE RD
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93108-2733
Country	:	US
Telephone Number	:	805-253-3623
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2021
Last Update Date	:	03/23/2021

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