Provider Demographics
NPI:1477628360
Name:MORGAN, SUZANNE M (LCSW)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:M
Last Name:MORGAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HUNTINGTON RD
Mailing Address - Street 2:SUITE 703
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-7204
Mailing Address - Country:US
Mailing Address - Phone:706-425-8900
Mailing Address - Fax:706-425-8600
Practice Address - Street 1:1 HUNTINGTON RD
Practice Address - Street 2:SUITE 703
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-7204
Practice Address - Country:US
Practice Address - Phone:706-425-8900
Practice Address - Fax:706-425-8600
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-24
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0030191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA80BBFPKMedicare ID - Type Unspecified