Provider Demographics
NPI:1326681081
Name:TICUM, MORGAN (LCMFT)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:TICUM
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8645 COLLEGE BLVD STE 125
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2034
Mailing Address - Country:US
Mailing Address - Phone:913-228-3056
Mailing Address - Fax:
Practice Address - Street 1:8645 COLLEGE BLVD STE 125
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2034
Practice Address - Country:US
Practice Address - Phone:913-228-3056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3150106H00000X
KS3084106H00000X
KS03186106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist