Provider Demographics
NPI:1073842530
Name:MORGAN, KELLY ANN (PC)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:ANN
Last Name:MORGAN
Suffix:
Gender:F
Credentials:PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13940 CEDAR RD # 206
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-3204
Mailing Address - Country:US
Mailing Address - Phone:440-379-1895
Mailing Address - Fax:888-388-7188
Practice Address - Street 1:3109 MAYFIELD RD STE 204
Practice Address - Street 2:
Practice Address - City:CLEVELAND HTS
Practice Address - State:OH
Practice Address - Zip Code:44118-1726
Practice Address - Country:US
Practice Address - Phone:440-591-4366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-12
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0800317101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional