MEDICARE: ANTHONY MORTON

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	1041C0700X	Clinical Social Worker	9385-S	NV

General Provider Information

NPI Number	:	1700458536
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY MORTON

Provider Business Mailing Address
First Line	:	8748 HARVEST VALLEY AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-7682
Country	:	US
Telephone Number	:	702-461-6751
Fax Number	:

Provider Business Practice Location Address
First Line	:	2520 SAINT ROSE PKWY
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-7783
Country	:	US
Telephone Number	:	702-913-5498
Fax Number	:

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

Provider Enumeration Date	:	07/12/2021
Last Update Date	:	08/03/2021

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