Provider Demographics
NPI:1730644766
Name:MORGAN, CARL J
Entity Type:Individual
Prefix:
First Name:CARL
Middle Name:J
Last Name:MORGAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14000 S MILITARY TRL STE 108
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-2600
Mailing Address - Country:US
Mailing Address - Phone:561-501-5260
Mailing Address - Fax:561-501-5263
Practice Address - Street 1:14000 S MILITARY TRL STE 108
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-2600
Practice Address - Country:US
Practice Address - Phone:561-501-5260
Practice Address - Fax:561-501-5263
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-04
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH323101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health