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NPI Code Detail

MEDICARE: MORGAN STILES LCSW138546

MEDICARE: MORGAN STILES LCSW138546
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1588315097
Entity Type Code : Individual
Provider Name (Legal Business Name) : MORGAN STILES LCSW138546
Provider Business Mailing Address
First Line : 3643 DEL BACIO AVE
Second Line :
City : HENDERSON
State : NV
Zip : 89044-2059
Country : US
Telephone Number : 805-861-7377
Fax Number :
Provider Business Practice Location Address
First Line : 31450 BROAD BEACH RD
Second Line :
City : MALIBU
State : CA
Zip : 90265-2669
Country : US
Telephone Number : 310-924-0780
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2022
Last Update Date : 05/12/2026

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