Healthcare Provider Details

I. General information

NPI: 1053902619
Provider Name (Legal Business Name): CORINNE JOY MORGAN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2021
Last Update Date: 01/27/2021
Certification Date: 01/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 E DIEHL RD STE 110
NAPERVILLE IL
60563-4808
US

IV. Provider business mailing address

17405 AVON LN
TINLEY PARK IL
60487-2204
US

V. Phone/Fax

Practice location:
  • Phone: 630-428-7890
  • Fax:
Mailing address:
  • Phone: 708-218-5856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178009302
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number790864
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: