Provider Demographics
NPI:1093865271
Name:MORGAN, PATRICIA ANN (PHD LCSW)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ANN
Last Name:MORGAN
Suffix:
Gender:F
Credentials:PHD LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10420 BRECKINRIDGE LANE
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-3419
Mailing Address - Country:US
Mailing Address - Phone:703-691-4968
Mailing Address - Fax:703-691-0187
Practice Address - Street 1:10400 EATON PLACE
Practice Address - Street 2:SUITE 110
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-3419
Practice Address - Country:US
Practice Address - Phone:703-273-9216
Practice Address - Fax:703-961-0187
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040004071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
10410666OtherCAQH UNIVERSAL CREDENTIAL