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General NPI Number Information
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NPI Number | 1811754302
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Entity Type | Individual
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Provider Name | MORGAN ASHLEY MCDANIEL LPC
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Gender | Female
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Dates
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Enumeration Date | 03/01/2024
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Last Update Date | 03/01/2024
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Provider Practice Location Address
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Address Line | 4010 N ILLINOIS ST STE D
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City | SWANSEA
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State | IL
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Zip | 62226-1967
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Country | US
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Telephone | 618-520-1764
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Fax | 618-825-9400
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Provider Business Mailing Address
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Address Line | 4 NOLES DR
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City | FAIRVIEW HEIGHTS
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State | IL
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Zip | 62208-1628
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Country | US
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Telephone | 618-409-6248
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Fax |
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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 | 178.019463
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License Number State | IL
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