Healthcare Provider Details

I. General information

NPI: 1992117998
Provider Name (Legal Business Name): KIMBERLY MAURINE MORGAN CSW-PIP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2014
Last Update Date: 05/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N SYCAMORE AVE
SIOUX FALLS SD
57110-5745
US

IV. Provider business mailing address

600 N SYCAMORE AVE
SIOUX FALLS SD
57110-5745
US

V. Phone/Fax

Practice location:
  • Phone: 605-328-2999
  • Fax:
Mailing address:
  • Phone: 605-328-2999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number3277
License Number StateSD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: