Healthcare Provider Details

I. General information

NPI: 1225722416
Provider Name (Legal Business Name): MORGAN BUMGARNER MSW, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2023
Last Update Date: 06/26/2024
Certification Date: 10/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 CROSS POINTE RD # 800D
COLUMBUS OH
43230-6687
US

IV. Provider business mailing address

495 NORTHVIEW DR
BEXLEY OH
43209-1051
US

V. Phone/Fax

Practice location:
  • Phone: 614-835-6068
  • Fax:
Mailing address:
  • Phone: 571-229-6982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2105947
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: