Provider Demographics
NPI:1114214327
Name:MORGAN-FULLILOVE, BEVERLY H (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:H
Last Name:MORGAN-FULLILOVE
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 1:70016 6TH ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-5497
Mailing Address - Country:US
Mailing Address - Phone:757-839-0789
Mailing Address - Fax:
Practice Address - Street 1:70016 6TH ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-5497
Practice Address - Country:US
Practice Address - Phone:757-839-0789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA144871041C0700X
VA09040015121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical