Provider Demographics
NPI:1760774871
Name:MORGAN, VIVIAN LUCILLE (LCPC)
Entity Type:Individual
Prefix:MS
First Name:VIVIAN
Middle Name:LUCILLE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1602 PROVIDENCE RD
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-1525
Mailing Address - Country:US
Mailing Address - Phone:443-377-0546
Mailing Address - Fax:
Practice Address - Street 1:1010 DULANEY VALLEY RD
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2702
Practice Address - Country:US
Practice Address - Phone:443-377-0546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-07
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3975101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional