Healthcare Provider Details

I. General information

NPI: 1033073499
Provider Name (Legal Business Name): RYAN CHASE MORGAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8945 W RUSSELL RD STE 110
LAS VEGAS NV
89148-1225
US

IV. Provider business mailing address

10115 JEFFREYS ST APT 2150
LAS VEGAS NV
89183-7922
US

V. Phone/Fax

Practice location:
  • Phone: 702-476-9294
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCI5648
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: