Healthcare Provider Details

I. General information

NPI: 1174153746
Provider Name (Legal Business Name): HALEY MEGAN MORSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2020
Last Update Date: 01/22/2020
Certification Date: 01/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 BRANSCOMB RD
LAYTONVILLE CA
95454-9545
US

IV. Provider business mailing address

1050 BRANSCOMB RD
LAYTONVILLE CA
95454-9705
US

V. Phone/Fax

Practice location:
  • Phone: 707-984-6131
  • Fax:
Mailing address:
  • Phone: 404-775-5555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number93801
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: