Healthcare Provider Details

I. General information

NPI: 1083207401
Provider Name (Legal Business Name): HILLARY MORGAN LLPC, LLMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2021
Last Update Date: 02/17/2021
Certification Date: 02/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 LAKE MICHIGAN DR NW
GRAND RAPIDS MI
49544
US

IV. Provider business mailing address

113 LAKE MICHIGAN DR NW
GRAND RAPIDS MI
49544
US

V. Phone/Fax

Practice location:
  • Phone: 616-425-2412
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401019035
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: