Provider Demographics
NPI:1619759297
Name:KETNER-WHITE, MORGAN BRIANNA (LCSW)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:BRIANNA
Last Name:KETNER-WHITE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6465 COLLEGE PARK SQ STE 300
Mailing Address - Street 2:
Mailing Address - City:VA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-3622
Mailing Address - Country:US
Mailing Address - Phone:757-351-0057
Mailing Address - Fax:757-351-6890
Practice Address - Street 1:6465 COLLEGE PARK SQ STE 300
Practice Address - Street 2:
Practice Address - City:VA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-3622
Practice Address - Country:US
Practice Address - Phone:757-351-0057
Practice Address - Fax:757-351-6890
Is Sole Proprietor?:No
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040143671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical