Provider Demographics
NPI:1023155777
Name:MORGAN, THERESA CATHERINE (CADC-I, QMHA)
Entity type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:CATHERINE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:CADC-I, QMHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5005 WIGRICH RD
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OR
Mailing Address - Zip Code:97351-9757
Mailing Address - Country:US
Mailing Address - Phone:503-580-1220
Mailing Address - Fax:
Practice Address - Street 1:5005 WIGRICH RD
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:OR
Practice Address - Zip Code:97351-9757
Practice Address - Country:US
Practice Address - Phone:503-580-1220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR051188U101YA0400X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered171M00000XOther Service ProvidersCase Manager/Care Coordinator