Healthcare Provider Details

I. General information

NPI: 1619503802
Provider Name (Legal Business Name): MORGAN MCKINLEY LCADC, LPCA, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2020
Last Update Date: 12/13/2023
Certification Date: 12/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4917 BROWNSBORO RD
LOUISVILLE KY
40222-6465
US

IV. Provider business mailing address

4615 SARATOGA HILL RD
LOUISVILLE KY
40299-4381
US

V. Phone/Fax

Practice location:
  • Phone: 501-208-6242
  • Fax:
Mailing address:
  • Phone: 270-779-8331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number281471
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number278546
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: