Healthcare Provider Details

I. General information

NPI: 1225163777
Provider Name (Legal Business Name): SUSAN THERESE MORGAN MSN BN CS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 BIGELOW ST
CAMBRIDGE MA
02139
US

IV. Provider business mailing address

25 MAYHEW ST
DORCHESTER MA
02125
US

V. Phone/Fax

Practice location:
  • Phone: 617-288-9721
  • Fax: 617-576-7435
Mailing address:
  • Phone: 617-282-1228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number209334
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: