Healthcare Provider Details

I. General information

NPI: 1497996151
Provider Name (Legal Business Name): CHRISTIANNA MORGAN MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2009
Last Update Date: 12/05/2022
Certification Date: 12/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 MOORE ST STE 303
BELMONT MA
02478-2525
US

IV. Provider business mailing address

21 BERKELEY ST
SOMERVILLE MA
02143-1603
US

V. Phone/Fax

Practice location:
  • Phone: 617-863-6626
  • Fax:
Mailing address:
  • Phone: 857-523-9566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number7705
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number313969
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: