Healthcare Provider Details

I. General information

NPI: 1154080281
Provider Name (Legal Business Name): JANELLE MORGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2021
Last Update Date: 12/16/2021
Certification Date: 12/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9107 PHILADELPHIA COURT SUITE M
LANHAM MD
20706
US

IV. Provider business mailing address

9107 PHILADELPHIA COURT SUITE M
LANHAM MD
20706
US

V. Phone/Fax

Practice location:
  • Phone: 301-210-4860
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number23411
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number23411
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: