Provider Demographics
NPI:1932504891
Name:MORGAN, AMY ALIDA AUDREY (CMHS, MHP, LMFTA)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:ALIDA AUDREY
Last Name:MORGAN
Suffix:
Gender:F
Credentials:CMHS, MHP, LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15419 NE 20TH ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-3800
Mailing Address - Country:US
Mailing Address - Phone:253-335-2480
Mailing Address - Fax:253-520-1799
Practice Address - Street 1:15419 NE 20TH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3800
Practice Address - Country:US
Practice Address - Phone:253-335-2480
Practice Address - Fax:253-520-1799
Is Sole Proprietor?:No
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG60324020106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist