Provider Demographics
NPI:1023807096
Name:WILT, MORGAN MARIE (ASSOCIATE)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:MARIE
Last Name:WILT
Suffix:
Gender:F
Credentials:ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3256 E 119TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-3825
Mailing Address - Country:US
Mailing Address - Phone:440-283-8441
Mailing Address - Fax:
Practice Address - Street 1:3256 E 119TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-3825
Practice Address - Country:US
Practice Address - Phone:440-283-8441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker