Provider Demographics
NPI:1629183330
Name:MORGAN, LAURA B (MA, LMFT, NCC)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:B
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MA, LMFT, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5230 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46953-5778
Mailing Address - Country:US
Mailing Address - Phone:765-674-2208
Mailing Address - Fax:765-674-3273
Practice Address - Street 1:5230 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46953-5778
Practice Address - Country:US
Practice Address - Phone:765-674-2208
Practice Address - Fax:765-674-3273
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35001595A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN35001595AOtherLMFT
IN63997OtherNCC
IN200530260AMedicaid
IN7910869OtherAETNA
IN000000873461OtherANTHEM BLUE CROSS BLUE SHIELD
IN254305-000OtherMAGELLAN