Healthcare Provider Details

I. General information

NPI: 1659631166
Provider Name (Legal Business Name): MORGAN ELIZABETH GAMBLE LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2012
Last Update Date: 07/11/2024
Certification Date: 07/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10344 OLD OCEAN CITY BLVD STE 2
BERLIN MD
21811-1162
US

IV. Provider business mailing address

PO BOX 1978
SALISBURY MD
21802-1978
US

V. Phone/Fax

Practice location:
  • Phone: 410-641-3340
  • Fax: 410-641-3341
Mailing address:
  • Phone: 410-749-1015
  • Fax: 410-749-0654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC14447
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: