MEDICARE: AMANDA MORGAN

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	P006108	NC
2	1041C0700X	Clinical Social Worker	CW018215	PA

General Provider Information

NPI Number	:	1851600423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA MORGAN

Provider Business Mailing Address
First Line	:	1631 DEL PRADO BLVD S STE 300-1041
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-6739
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1631 DEL PRADO BLVD S STE 300-1041
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-6739
Country	:	US
Telephone Number	:	904-601-5463
Fax Number	:

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

Provider Enumeration Date	:	09/30/2010
Last Update Date	:	10/06/2023

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Directions to “ AMANDA MORGAN ” Practice Location

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