MEDICARE: KENETHIA LOUISE MORGAN LCSW

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	104100000X	Social Worker
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1699112979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENETHIA LOUISE MORGAN LCSW

Provider Business Mailing Address
First Line	:	16318 BLUE ROCK SPRINGS DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77073-5602
Country	:	US
Telephone Number	:	504-270-6615
Fax Number	:

Provider Business Practice Location Address
First Line	:	16318 BLUE ROCK SPRINGS DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77073-5602
Country	:	US
Telephone Number	:	504-270-6615
Fax Number	:

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

Provider Enumeration Date	:	05/28/2013
Last Update Date	:	09/09/2018

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