Provider Demographics
NPI:1205346822
Name:SACKENHEIM, MORGAN (MASW, LSW)
Entity type:Individual
Prefix:MS
First Name:MORGAN
Middle Name:
Last Name:SACKENHEIM
Suffix:
Gender:F
Credentials:MASW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5339 DELLBROOK DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-3319
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8351 PLAINFIELD RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2445
Practice Address - Country:US
Practice Address - Phone:513-672-3822
Practice Address - Fax:513-891-3845
Is Sole Proprietor?:No
Enumeration Date:2017-10-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.16003641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical