MEDICARE: IMANI ALICIA MORGAN LMSW

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	7796	CT

General Provider Information

NPI Number	:	1982462511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IMANI ALICIA MORGAN LMSW

Provider Business Mailing Address
First Line	:	265 MONTAUK DR
Second Line	:
City	:	STAMFORD
State	:	CT
Zip	:	06902-6406
Country	:	US
Telephone Number	:	203-826-4162
Fax Number	:

Provider Business Practice Location Address
First Line	:	401 SHIPPAN AVE STE 104
Second Line	:
City	:	STAMFORD
State	:	CT
Zip	:	06902-6075
Country	:	US
Telephone Number	:	203-826-4162
Fax Number	:

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

Provider Enumeration Date	:	03/08/2024
Last Update Date	:	03/08/2024

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