Provider Demographics
NPI:1710314802
Name:MORGAN, BENJAMIN MASTERS (BA)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:MASTERS
Last Name:MORGAN
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 ASHFORD ST APT 2
Mailing Address - Street 2:
Mailing Address - City:ALLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02134-1812
Mailing Address - Country:US
Mailing Address - Phone:978-968-7712
Mailing Address - Fax:
Practice Address - Street 1:800 CUMMINGS CTR STE 364U
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6174
Practice Address - Country:US
Practice Address - Phone:978-726-8107
Practice Address - Fax:978-922-0098
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor