Healthcare Provider Details

I. General information

NPI: 1578170007
Provider Name (Legal Business Name): MORGAN LEIGH JOHNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2020
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 WAYNE FRYE DR
MANCHESTER OH
45144-9314
US

IV. Provider business mailing address

PO BOX 799
PIKETON OH
45661-0799
US

V. Phone/Fax

Practice location:
  • Phone: 937-549-1270
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.2507125
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: