MEDICARE: MS. VIVIAN LUCILLE MORGAN LCPC

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	101YP2500X	Professional Counselor	LC3975	MD

General Provider Information

NPI Number	:	1760774871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VIVIAN LUCILLE MORGAN LCPC

Provider Business Mailing Address
First Line	:	1602 PROVIDENCE RD
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21286-1525
Country	:	US
Telephone Number	:	443-377-0546
Fax Number	:

Provider Business Practice Location Address
First Line	:	1010 DULANEY VALLEY RD
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21204-2702
Country	:	US
Telephone Number	:	443-377-0546
Fax Number	:

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

Provider Enumeration Date	:	05/07/2011
Last Update Date	:	01/19/2024

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