Provider Demographics
NPI:1497179097
Name:MORGAN, JO (LISW)
Entity Type:Individual
Prefix:
First Name:JO
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11080 CHESTER RD
Mailing Address - Street 2:
Mailing Address - City:CINTI
Mailing Address - State:OH
Mailing Address - Zip Code:45246
Mailing Address - Country:US
Mailing Address - Phone:513-864-1603
Mailing Address - Fax:
Practice Address - Street 1:11080 CHESTER RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-3802
Practice Address - Country:US
Practice Address - Phone:513-864-1603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-18
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOHI-30-8602101Y00000X
OHI.0005593104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker