Provider Demographics
NPI:1114012812
Name:VANCE, MORGAN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:
Last Name:VANCE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4043 N RAVENSWOOD AVE STE 216-6
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-1155
Mailing Address - Country:US
Mailing Address - Phone:414-704-9645
Mailing Address - Fax:
Practice Address - Street 1:4043 N RAVENSWOOD AVE STE 216-6
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-1155
Practice Address - Country:US
Practice Address - Phone:414-704-9645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7900-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical