Healthcare Provider Details

I. General information

NPI: 1306760400
Provider Name (Legal Business Name): MS. TANYA MARIE MORGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 N MAIN AVE
LOVINGTON NM
88260-2813
US

IV. Provider business mailing address

PO BOX 1954
LOVINGTON NM
88260-1954
US

V. Phone/Fax

Practice location:
  • Phone: 575-396-6611
  • Fax:
Mailing address:
  • Phone: 830-563-7015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number102107
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: