Provider Demographics
NPI:1437159712
Name:MORGAN, SCOTT M (LICSW)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:M
Last Name:MORGAN
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 125
Mailing Address - Street 2:
Mailing Address - City:EAGLE LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:56024-0125
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 REED ST
Practice Address - Street 2:SUITE 115
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-6410
Practice Address - Country:US
Practice Address - Phone:507-625-4060
Practice Address - Fax:507-625-3915
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1163781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN130980D113OtherUCARE OF MINNESOTA
MNHP42080OtherHEALTH PARTNERS
MN415T2MOOtherBLUE CROSS BLUE SHIELD
MN834629100Medicaid
MN834629100Medicaid