MEDICARE: MORGAN SANFORD LMSW

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	1041C0700X	Clinical Social Worker	MSW012101	GA

General Provider Information

NPI Number	:	1306658414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MORGAN SANFORD LMSW

Provider Business Mailing Address
First Line	:	4533 PEPPERMILL PL NW
Second Line	:
City	:	ACWORTH
State	:	GA
Zip	:	30101-8301
Country	:	US
Telephone Number	:	517-282-9412
Fax Number	:

Provider Business Practice Location Address
First Line	:	3535 ROSWELL RD STE 38
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30062-8829
Country	:	US
Telephone Number	:	517-282-9412
Fax Number	:

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

Provider Enumeration Date	:	01/24/2025
Last Update Date	:	01/24/2025

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