Healthcare Provider Details

I. General information

NPI: 1992372668
Provider Name (Legal Business Name): STEPHANIE K MORGAN ASW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2021
Last Update Date: 09/01/2022
Certification Date: 08/30/2022
Deactivation Date: 07/27/2021
Reactivation Date: 08/30/2022

III. Provider practice location address

3861 SEPULVEDA BLVD
CULVER CITY CA
90230-4605
US

IV. Provider business mailing address

22647 VENTURA BLVD # 405
WOODLAND HILLS CA
91364-1416
US

V. Phone/Fax

Practice location:
  • Phone: 310-450-2191
  • Fax:
Mailing address:
  • Phone: 818-268-5757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberASW103135
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW103135
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: