Provider Demographics
NPI:1801385570
Name:CLEVIDENCE, MORGAN NICOLLE (LPCC-S)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:NICOLLE
Last Name:CLEVIDENCE
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 CROSSING CIRCLE CT
Mailing Address - Street 2:
Mailing Address - City:NEW RICHMOND
Mailing Address - State:OH
Mailing Address - Zip Code:45157-9440
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:110 CROSSING CIRCLE CT
Practice Address - Street 2:
Practice Address - City:NEW RICHMOND
Practice Address - State:OH
Practice Address - Zip Code:45157-9440
Practice Address - Country:US
Practice Address - Phone:330-535-8181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-08
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA163004101YA0400X
OHE.2102247101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)