Provider Demographics
NPI:1447997069
Name:MORGAN, CAROL L (LADC-MH CANDIDATE)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:L
Last Name:MORGAN
Suffix:
Gender:F
Credentials:LADC-MH CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 N FRETZ AVE APT 60
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73003-5058
Mailing Address - Country:US
Mailing Address - Phone:405-625-1798
Mailing Address - Fax:
Practice Address - Street 1:10400 VINEYARD BLVD STE H200
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-3830
Practice Address - Country:US
Practice Address - Phone:405-607-2995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)