Healthcare Provider Details

I. General information

NPI: 1669077467
Provider Name (Legal Business Name): MORGAN STEVENS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2020
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1615 PASADENA AVE S STE 330
SOUTH PASADENA FL
33707-4567
US

IV. Provider business mailing address

1615 PASADENA AVE S STE 330
SOUTH PASADENA FL
33707-4567
US

V. Phone/Fax

Practice location:
  • Phone: 847-380-0420
  • Fax:
Mailing address:
  • Phone: 847-380-0420
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. MORGAN G STEVENS JR.
Title or Position: THERAPIST
Credential:
Phone: 847-380-0420