Provider Demographics
NPI:1912549668
Name:MORGAN, KERRY L (LSW)
Entity Type:Individual
Prefix:MR
First Name:KERRY
Middle Name:L
Last Name:MORGAN
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1541 STANTON AVE
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-2538
Mailing Address - Country:US
Mailing Address - Phone:740-221-1460
Mailing Address - Fax:
Practice Address - Street 1:2805 PINKERTON LN
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-8593
Practice Address - Country:US
Practice Address - Phone:740-453-4509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-15
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.19033754104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker