Provider Demographics
NPI:1033140405
Name:MORGAN, KATHLEEN MARY (MSW)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:MARY
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:939 OFFICE PARK RD
Mailing Address - Street 2:STE200
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-2505
Mailing Address - Country:US
Mailing Address - Phone:515-226-2507
Mailing Address - Fax:515-440-3388
Practice Address - Street 1:939 OFFICE PARK RD
Practice Address - Street 2:STE200
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-2505
Practice Address - Country:US
Practice Address - Phone:515-226-2507
Practice Address - Fax:515-440-3388
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0014316Medicaid
IA42105384450265A007OtherTRIWEST
IA01431OtherWELLMARK BC
IA7375OtherMIDLANDS
IA01431OtherWELLMARK BC