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General NPI Number Information
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NPI Number | 1649493081
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Entity Type | Individual
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Provider Name | MORGAN THOMAS JACKSON M.A.
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Gender | Male
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 03/28/2024
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Provider Practice Location Address
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Address Line | 415 PEANUT DR
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City | TEMPLE
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State | TX
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Zip | 76502-5290
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Country | US
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Telephone | 254-541-6044
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Fax | 254-320-0124
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Provider Business Mailing Address
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Address Line | PO BOX 902
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City | TEMPLE
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State | TX
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Zip | 76503-0902
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Country | US
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Telephone | 254-541-6044
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Fax | 254-773-7902
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 61282
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License Number State | TX
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