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NPI Code Detail

MEDICARE: MORGAN MENTAL HEALTH GROUP LLC

MEDICARE: MORGAN MENTAL HEALTH GROUP LLC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor
2101YP2500XProfessional Counselor
3103TC0700XClinical Psychologist
4104100000XSocial Worker
51041C0700XClinical Social Worker
6101Y00000XCounselor
7363LF0000XFamily Nurse Practitioner
8101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1457993230
Entity Type Code : Organization
Provider Name (Legal Business Name) : MORGAN MENTAL HEALTH GROUP LLC
Provider Business Mailing Address
First Line : 1901 N LAKES PL
Second Line :
City : MERIDIAN
State : ID
Zip : 83646-5939
Country : US
Telephone Number : 208-890-7165
Fax Number : 208-936-4850
Provider Business Practice Location Address
First Line : 1901 N LAKES PL
Second Line :
City : MERIDIAN
State : ID
Zip : 83646-5939
Country : US
Telephone Number : 208-890-7165
Fax Number : 208-936-4850
Authorized Official
Title or Position : MEMBER
Name : MRS. TAMI MORGAN
Credential : LPC
Telephone Number : 208-890-7165
Provider Enumeration Date : 10/12/2019
Last Update Date : 11/05/2024

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