Provider Demographics
NPI:1477029668
Name:VANDERMEER, MORGAN (LCMHC)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:VANDERMEER
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:
Other - Last Name:HARVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3708 WIND RIDGE PL
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-9008
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3708 WIND RIDGE PL
Practice Address - Street 2:
Practice Address - City:WAXHAW
Practice Address - State:NC
Practice Address - Zip Code:28173-9008
Practice Address - Country:US
Practice Address - Phone:336-899-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-16
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14393101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty