Healthcare Provider Details

I. General information

NPI: 1437066230
Provider Name (Legal Business Name): ANDRE LEROY MORGAN JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3439 MAGNOLIA AVE
ZACHARY LA
70791-4460
US

IV. Provider business mailing address

3439 MAGNOLIA AVE
ZACHARY LA
70791-4460
US

V. Phone/Fax

Practice location:
  • Phone: 504-919-3753
  • Fax:
Mailing address:
  • Phone: 504-919-3753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2024012553
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: