Provider Demographics
NPI:1245002880
Name:WHITE, MORGAN ELISSA (MS, LMFT)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:ELISSA
Last Name:WHITE
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 LINCOLN VILLAGE CIR APT 2252
Mailing Address - Street 2:
Mailing Address - City:LARKSPUR
Mailing Address - State:CA
Mailing Address - Zip Code:94939-1677
Mailing Address - Country:US
Mailing Address - Phone:415-671-9382
Mailing Address - Fax:
Practice Address - Street 1:1800 LINCOLN VILLAGE CIR APT 2252
Practice Address - Street 2:
Practice Address - City:LARKSPUR
Practice Address - State:CA
Practice Address - Zip Code:94939-1677
Practice Address - Country:US
Practice Address - Phone:415-671-9382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA136857106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist