Provider Demographics
NPI:1164859963
Name:MORGAN, CHARLES ALEXANDER III (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ALEXANDER
Last Name:MORGAN
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 CHURCH ST STE 301
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-1807
Mailing Address - Country:US
Mailing Address - Phone:203-376-9979
Mailing Address - Fax:
Practice Address - Street 1:234 CHURCH ST STE 301
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-1807
Practice Address - Country:US
Practice Address - Phone:203-376-9979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-11
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT031148103TB0200X, 103TP0016X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral