Provider Demographics
NPI:1275652588
Name:MORGAN, JODIE TAYLOR (MASTER'S)
Entity Type:Individual
Prefix:MRS
First Name:JODIE
Middle Name:TAYLOR
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MASTER'S
Other - Prefix:MRS
Other - First Name:JOSEPHINE
Other - Middle Name:TAYLOR
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MASTER'S
Mailing Address - Street 1:257 HOBCAW DR
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-2568
Mailing Address - Country:US
Mailing Address - Phone:843-884-3340
Mailing Address - Fax:
Practice Address - Street 1:1233 BEN SAWYER BLVD
Practice Address - Street 2:SUITE 700
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-4577
Practice Address - Country:US
Practice Address - Phone:843-884-3332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC0039621041C0700X
SC0159106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist