MEDICARE: MRS. MORGAN ANGEL MS

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	101YM0800X	Mental Health Counselor	LPCC4450	CA
2	101YM0800X	Mental Health Counselor	MH14061	FL

General Provider Information

NPI Number	:	1316497266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MORGAN ANGEL MS

Provider Business Mailing Address
First Line	:	1720 W FAIRFIELD DR STE 305
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32501-1057
Country	:	US
Telephone Number	:	850-341-0683
Fax Number	:

Provider Business Practice Location Address
First Line	:	1720 W FAIRFIELD DR STE 305
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32501-1057
Country	:	US
Telephone Number	:	850-341-0683
Fax Number	:

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

Provider Enumeration Date	:	10/04/2016
Last Update Date	:	02/09/2019

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