Provider Demographics
NPI:1609396951
Name:MORGAN, ELEANORA (LADC)
Entity Type:Individual
Prefix:MS
First Name:ELEANORA
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:NORIE
Other - Middle Name:T
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:336 MIDLAND ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06605-3546
Mailing Address - Country:US
Mailing Address - Phone:203-856-1002
Mailing Address - Fax:
Practice Address - Street 1:336 MIDLAND ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06605-3546
Practice Address - Country:US
Practice Address - Phone:203-856-1002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1220101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)