Provider Demographics
NPI:1992372668
Name:MORGAN, STEPHANIE K (ASW)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:K
Last Name:MORGAN
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22647 VENTURA BLVD # 405
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1416
Mailing Address - Country:US
Mailing Address - Phone:818-268-5757
Mailing Address - Fax:
Practice Address - Street 1:3861 SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-4605
Practice Address - Country:US
Practice Address - Phone:310-450-2191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2022-09-01
Deactivation Date:2021-07-27
Deactivation Code:
Reactivation Date:2022-08-30
Provider Licenses
StateLicense IDTaxonomies
CAASW103135101Y00000X, 104100000X
225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner