Healthcare Provider Details

I. General information

NPI: 1851887939
Provider Name (Legal Business Name): ANDREA C MORGAN MS, CASAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2018
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

727 N BROADWAY STE C1
MASSAPEQUA NY
11758-2348
US

IV. Provider business mailing address

1693 HOLLY ST
NORTH BALDWIN NY
11510-2452
US

V. Phone/Fax

Practice location:
  • Phone: 631-938-9119
  • Fax:
Mailing address:
  • Phone: 718-210-7234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP134675
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: