Provider Demographics
NPI:1073968426
Name:MORGAN, MELANIE D (ACMHC)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:D
Last Name:MORGAN
Suffix:
Gender:F
Credentials:ACMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 E 1200 S # L4
Mailing Address - Street 2:
Mailing Address - City:HEBER CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84032-3943
Mailing Address - Country:US
Mailing Address - Phone:801-350-1671
Mailing Address - Fax:
Practice Address - Street 1:425 E 1200 S # L4
Practice Address - Street 2:
Practice Address - City:HEBER CITY
Practice Address - State:UT
Practice Address - Zip Code:84032-3943
Practice Address - Country:US
Practice Address - Phone:801-350-1671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-03
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT112139-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health