Healthcare Provider Details

I. General information

NPI: 1295661148
Provider Name (Legal Business Name): EARNEL JAY MORGAN III
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JAY MORGAN MA

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 94
BRENTON WV
24818-0094
US

IV. Provider business mailing address

PO BOX 94
BRENTON WV
24818-0094
US

V. Phone/Fax

Practice location:
  • Phone: 304-763-8815
  • Fax:
Mailing address:
  • Phone: 304-763-8815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: