Provider Demographics
NPI:1295401909
Name:MORGAN, BETHANY (LPC-A)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5380 OLD BULLARD RD STE 600-430
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-3607
Mailing Address - Country:US
Mailing Address - Phone:903-224-5150
Mailing Address - Fax:
Practice Address - Street 1:5380 OLD BULLARD RD STE 600-430
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-3607
Practice Address - Country:US
Practice Address - Phone:903-224-5150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-22
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83292101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health