Provider Demographics
NPI:1891194411
Name:MORGAN, MARLON (LPCC)
Entity Type:Individual
Prefix:
First Name:MARLON
Middle Name:
Last Name:MORGAN
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 HARDING BLVD
Mailing Address - Street 2:STE # 206
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95678-2470
Mailing Address - Country:US
Mailing Address - Phone:916-251-9707
Mailing Address - Fax:
Practice Address - Street 1:300 HARDING BLVD
Practice Address - Street 2:STE # 206
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95678-2470
Practice Address - Country:US
Practice Address - Phone:916-251-9707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-19
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA795101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional