Healthcare Provider Details

I. General information

NPI: 1093523748
Provider Name (Legal Business Name): MORGAN A CROFT-SCHORNAK LGSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2024
Last Update Date: 12/27/2024
Certification Date: 12/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

804 INDUSTRIAL DRIVE
MAXWELTON WV
24957
US

IV. Provider business mailing address

131 WELLNESS DR
SUMMERSVILLE WV
26651-5402
US

V. Phone/Fax

Practice location:
  • Phone: 304-497-0500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberBP00947036
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: