Provider Demographics
NPI:1619212578
Name:MORGAN, PAMELA TERESA (LMFT)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:TERESA
Last Name:MORGAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:
Other - Last Name:FONTENOT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4003 WHITE SANDS DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70814-5171
Mailing Address - Country:US
Mailing Address - Phone:225-936-3433
Mailing Address - Fax:225-273-7748
Practice Address - Street 1:4003 WHITE SANDS DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70814-5171
Practice Address - Country:US
Practice Address - Phone:225-936-3433
Practice Address - Fax:225-273-7748
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-04
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAN 005216101YS0200X
LALMFT 490106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool