MEDICARE: VICKI MORGAN LMFT, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	2014027059	MO
2	101YP2500X	Professional Counselor	LPC011407	GA
3	106H00000X	Marriage & Family Therapist	M2204000	AR
4	106H00000X	Marriage & Family Therapist	2018027917	MO
5	101YP2500X	Professional Counselor	P2102158	AR

General Provider Information

NPI Number	:	1285318444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICKI MORGAN LMFT, LPC

Provider Business Mailing Address
First Line	:	758 RHEAS MILL RD
Second Line	:
City	:	FARMINGTON
State	:	AR
Zip	:	72730-8719
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1725 S SMOKEHOUSE TRL
Second Line	:
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72701-7711
Country	:	US
Telephone Number	:	417-593-1188
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2023
Last Update Date	:	06/09/2023

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Directions to “ VICKI MORGAN LMFT, LPC” Practice Location

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