MEDICARE: MORGAN UNDERWOOD LMFT, LCADC, LCS

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	2628	NV
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	06594	NV

General Provider Information

NPI Number	:	1396146783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MORGAN UNDERWOOD LMFT, LCADC, LCS

Provider Business Mailing Address
First Line	:	4722 OBANNON DR APT D
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-3575
Country	:	US
Telephone Number	:	702-417-8513
Fax Number	:

Provider Business Practice Location Address
First Line	:	4011 MCLEOD DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-4305
Country	:	US
Telephone Number	:	702-479-1573
Fax Number	:

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

Provider Enumeration Date	:	09/04/2014
Last Update Date	:	07/30/2023

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