Provider Demographics
NPI:1063009397
Name:GAGAS, MORGAN (MS, LPC)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:GAGAS
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 W GENEVA ST STE 2
Mailing Address - Street 2:
Mailing Address - City:WILLIAMS BAY
Mailing Address - State:WI
Mailing Address - Zip Code:53191-9562
Mailing Address - Country:US
Mailing Address - Phone:262-607-2770
Mailing Address - Fax:
Practice Address - Street 1:93 W GENEVA ST STE 2
Practice Address - Street 2:
Practice Address - City:WILLIAMS BAY
Practice Address - State:WI
Practice Address - Zip Code:53191-9562
Practice Address - Country:US
Practice Address - Phone:262-607-2770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8040125101YM0800X
WI8040-125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health