Healthcare Provider Details

I. General information

NPI: 1609602291
Provider Name (Legal Business Name): MONIQUE EVON MORGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2024
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 WERNER CT STE 200
CASPER WY
82601-1324
US

IV. Provider business mailing address

800 WERNER CT STE 200
CASPER WY
82601-1324
US

V. Phone/Fax

Practice location:
  • Phone: 307-265-7366
  • Fax:
Mailing address:
  • Phone: 307-333-1301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1266
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: