Healthcare Provider Details

I. General information

NPI: 1972548501
Provider Name (Legal Business Name): DILLON BROOKE MORRIGAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BROOKE MORRIGAN LCSW

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 04/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8830 CAMERON ST SUITE 207
SILVER SPRING MD
20910-4114
US

IV. Provider business mailing address

2202 RICHLAND PL
SILVER SPRING MD
20910-2331
US

V. Phone/Fax

Practice location:
  • Phone: 202-329-7160
  • Fax:
Mailing address:
  • Phone: 202-319-7160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14457
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number50078565
License Number StateDC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier197929
Identifier TypeOTHER
Identifier State
Identifier IssuerPTAN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: