MEDICARE: KATRINA MORGAN LCSW

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	1041C0700X	Clinical Social Worker	60999	TX

General Provider Information

NPI Number	:	1447750757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATRINA MORGAN LCSW

Provider Business Mailing Address
First Line	:	2210 FIELD LN
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-5104
Country	:	US
Telephone Number	:	805-340-0675
Fax Number	:

Provider Business Practice Location Address
First Line	:	3733 GLASSENBERRY ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-8697
Country	:	US
Telephone Number	:	805-340-0675
Fax Number	:

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

Provider Enumeration Date	:	02/14/2018
Last Update Date	:	11/06/2020

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