Provider Demographics
NPI:1376156257
Name:MORGAN, TAMEIKA T
Entity Type:Individual
Prefix:
First Name:TAMEIKA
Middle Name:T
Last Name:MORGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10632 SW VISCONTI WAY
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-2878
Mailing Address - Country:US
Mailing Address - Phone:561-670-0130
Mailing Address - Fax:
Practice Address - Street 1:567 NW LAKE WHITNEY PL STE 101
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-1629
Practice Address - Country:US
Practice Address - Phone:561-670-0130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health