Provider Demographics
NPI:1467471227
Name:MORGAN, PAULA (PHD)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 JOHN HARPER RD
Mailing Address - Street 2:STE 14
Mailing Address - City:SHEPHERDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40165-7463
Mailing Address - Country:US
Mailing Address - Phone:502-955-1022
Mailing Address - Fax:502-955-1022
Practice Address - Street 1:815 JOHN HARPER RD
Practice Address - Street 2:STE 14
Practice Address - City:SHEPHERDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40165-7463
Practice Address - Country:US
Practice Address - Phone:502-955-1022
Practice Address - Fax:502-955-1022
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY128907103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0938408Medicare PIN
KYQ30840Medicare UPIN