Provider Demographics
NPI:1558849547
Name:BARACKMAN, MORGAN (MED, NCC)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:BARACKMAN
Suffix:
Gender:F
Credentials:MED, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11041 OAK FOREST PARKWAY DR APT F
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-1935
Mailing Address - Country:US
Mailing Address - Phone:618-806-6216
Mailing Address - Fax:
Practice Address - Street 1:8240 SAINT CHARLES ROCK RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63114-4508
Practice Address - Country:US
Practice Address - Phone:314-427-3755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-01
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional