Provider Demographics
NPI:1134157670
Name:MORGAN, SANDRA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 SADDLETREE RD
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28360-8247
Mailing Address - Country:US
Mailing Address - Phone:910-739-0008
Mailing Address - Fax:
Practice Address - Street 1:2311 SADDLETREE RD
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28360-8247
Practice Address - Country:US
Practice Address - Phone:910-739-0008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0015591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6003521Medicaid
NC6003521Medicaid