Provider Demographics
NPI:1871306324
Name:MORGAN, SETH DERRICK
Entity type:Individual
Prefix:
First Name:SETH
Middle Name:DERRICK
Last Name:MORGAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1764 LAWRENCE AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38112-5304
Mailing Address - Country:US
Mailing Address - Phone:901-907-9371
Mailing Address - Fax:
Practice Address - Street 1:1764 LAWRENCE AVE APT 4
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38112-5304
Practice Address - Country:US
Practice Address - Phone:901-907-9371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker