Provider Demographics
NPI:1275065922
Name:MORGAN, CHARLES REX (LCSW)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:REX
Last Name:MORGAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 N 1200 W
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-2445
Mailing Address - Country:US
Mailing Address - Phone:801-229-1181
Mailing Address - Fax:801-229-2787
Practice Address - Street 1:1255 N 1200 W
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-2445
Practice Address - Country:US
Practice Address - Phone:801-229-1181
Practice Address - Fax:801-229-2787
Is Sole Proprietor?:No
Enumeration Date:2017-03-31
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
UT10834468-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program