MEDICARE: MORGAN O'SHAUGHNESSY

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	101YM0800X	Mental Health Counselor	MH15935	FL

General Provider Information

NPI Number	:	1407479876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MORGAN O'SHAUGHNESSY

Provider Business Mailing Address
First Line	:	557 PLATT CIR
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32904-2530
Country	:	US
Telephone Number	:	321-266-1404
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 S HARBOR CITY BLVD
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32901-1319
Country	:	US
Telephone Number	:	321-266-1404
Fax Number	:

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

Provider Enumeration Date	:	05/20/2020
Last Update Date	:	05/20/2020

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Directions to “ MORGAN O'SHAUGHNESSY ” Practice Location

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