MEDICARE: MRS. MORGAN RENEE DUPERROIR LPC

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	7489	OK

General Provider Information

NPI Number	:	1699250399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MORGAN RENEE DUPERROIR LPC

Provider Business Mailing Address
First Line	:	1809 NW 41ST ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118-2407
Country	:	US
Telephone Number	:	918-576-8145
Fax Number	:

Provider Business Practice Location Address
First Line	:	7804 NW 89TH ST STE 1
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73132-3213
Country	:	US
Telephone Number	:	405-655-8615
Fax Number	:

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

Provider Enumeration Date	:	09/27/2018
Last Update Date	:	10/05/2021

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