Healthcare Provider Details

I. General information

NPI: 1053959601
Provider Name (Legal Business Name): MCKENZIE MORGAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2019
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

377 E RIVERSIDE DR BLDG B
ST GEORGE UT
84790-8013
US

IV. Provider business mailing address

377 E RIVERSIDE DR STE B
ST GEORGE UT
84790-4749
US

V. Phone/Fax

Practice location:
  • Phone: 435-229-9511
  • Fax:
Mailing address:
  • Phone: 435-862-8273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number11435466-3502
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11435466-3501
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: