Provider Demographics
NPI:1801044516
Name:MORGAN, CHARLES PETER (LMFT)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:PETER
Last Name:MORGAN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 BURNS AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55106-6603
Mailing Address - Country:US
Mailing Address - Phone:651-774-5503
Mailing Address - Fax:
Practice Address - Street 1:1505 BURNS AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55106-6603
Practice Address - Country:US
Practice Address - Phone:651-774-5503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-05
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3786101YM0800X
CA57559101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN3786OtherCLINICAL LICENSE