Healthcare Provider Details

I. General information

NPI: 1659357085
Provider Name (Legal Business Name): C. DENISE MORGAN-IRISH LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/18/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1128 PARCHED CORN RD
ROGERSVILLE MO
65742-8548
US

IV. Provider business mailing address

1128 PARCHED CORN RD
ROGERSVILLE MO
65742-8548
US

V. Phone/Fax

Practice location:
  • Phone: 417-581-5852
  • Fax: 417-581-5852
Mailing address:
  • Phone: 417-581-5852
  • Fax: 417-581-5852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number003992
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: