Provider Demographics
NPI:1649563529
Name:MCMORROUGH, VICKI ANN (LPC)
Entity Type:Individual
Prefix:MS
First Name:VICKI
Middle Name:ANN
Last Name:MCMORROUGH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 NORTH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:GA
Mailing Address - Zip Code:30528-1398
Mailing Address - Country:US
Mailing Address - Phone:706-348-3674
Mailing Address - Fax:706-348-8676
Practice Address - Street 1:42 NORTH AVE STE 100
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:GA
Practice Address - Zip Code:30528-1398
Practice Address - Country:US
Practice Address - Phone:706-348-8674
Practice Address - Fax:706-348-8676
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-25
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003340101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health