Provider Demographics
NPI:1912554148
Name:IKONNE, MORGAN N (MS PSY CAADC)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:N
Last Name:IKONNE
Suffix:
Gender:M
Credentials:MS PSY CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1541 CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-1826
Mailing Address - Country:US
Mailing Address - Phone:302-317-2212
Mailing Address - Fax:
Practice Address - Street 1:11 PARKWAY CIR
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-4077
Practice Address - Country:US
Practice Address - Phone:302-317-2212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-22
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)