Provider Demographics
NPI:1578203550
Name:GIRTMAN, MORGAN VAN SCIVER (MSW, LSW, CGP)
Entity Type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:VAN SCIVER
Last Name:GIRTMAN
Suffix:
Gender:F
Credentials:MSW, LSW, CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4211 DUNEDIN CT
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46062-7390
Mailing Address - Country:US
Mailing Address - Phone:910-297-5403
Mailing Address - Fax:
Practice Address - Street 1:8904 BASH ST STE B
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-1286
Practice Address - Country:US
Practice Address - Phone:317-951-6659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33008671A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker