Provider Demographics
NPI:1871801720
Name:ANDERSON, MORGAN (PHD)
Entity type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:
Other - Last Name:HANSMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:3 IRVING RD
Mailing Address - Street 2:
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-4029
Mailing Address - Country:US
Mailing Address - Phone:516-455-9480
Mailing Address - Fax:
Practice Address - Street 1:3 IRVING RD
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-4029
Practice Address - Country:US
Practice Address - Phone:516-455-9480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-14
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018585103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY018585OtherNYS PSYCHOLOGIST LICENSE #