Healthcare Provider Details

I. General information

NPI: 1790282994
Provider Name (Legal Business Name): DEONA SIMONE MORTON PHD, LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2018
Last Update Date: 09/08/2024
Certification Date: 09/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8609 2ND AVE STE 404B
SILVER SPRING MD
20910-3374
US

IV. Provider business mailing address

8609 2ND AVE STE 404B
SILVER SPRING MD
20910-3374
US

V. Phone/Fax

Practice location:
  • Phone: 443-345-8951
  • Fax: 855-240-5184
Mailing address:
  • Phone: 443-345-8951
  • Fax: 888-568-6057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLGP8570
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLC10383
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: