Provider Demographics
NPI:1225379761
Name:MORGAN, PHILIP (MA)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:
Last Name:MORGAN
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2959 UMI ST STE 300
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-1806
Mailing Address - Country:US
Mailing Address - Phone:808-245-2873
Mailing Address - Fax:808-245-6957
Practice Address - Street 1:2959 UMI ST STE 300
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1806
Practice Address - Country:US
Practice Address - Phone:808-245-2873
Practice Address - Fax:808-245-6957
Is Sole Proprietor?:No
Enumeration Date:2013-03-07
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00006352101YM0800X
HI101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health