Healthcare Provider Details

I. General information

NPI: 1588315097
Provider Name (Legal Business Name): MORGAN STILES LCSW138546
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2022
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31450 BROAD BEACH RD
MALIBU CA
90265-2669
US

IV. Provider business mailing address

3643 DEL BACIO AVE
HENDERSON NV
89044-2059
US

V. Phone/Fax

Practice location:
  • Phone: 310-924-0780
  • Fax:
Mailing address:
  • Phone: 805-861-7377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number138546
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: