Provider Demographics
NPI:1972003770
Name:DICKERSON, MORGAN ELIZABETH (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:MORGAN
Middle Name:ELIZABETH
Last Name:DICKERSON
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9241 OLD STATE HWY UNIT 1170
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:CA
Mailing Address - Zip Code:95658-1447
Mailing Address - Country:US
Mailing Address - Phone:818-274-8987
Mailing Address - Fax:
Practice Address - Street 1:9241 OLD STATE HWY #1170
Practice Address - Street 2:
Practice Address - City:NEWCASTLE
Practice Address - State:CA
Practice Address - Zip Code:95658
Practice Address - Country:US
Practice Address - Phone:818-274-8987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-19
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA938201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical