Provider Demographics
NPI:1255956496
Name:MORGAN SHEPARD, HALEY DYAN (LPCC)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:DYAN
Last Name:MORGAN SHEPARD
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:DYAN
Other - Last Name:SHEPARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC
Mailing Address - Street 1:14949 62ND ST N
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-6132
Mailing Address - Country:US
Mailing Address - Phone:651-430-8344
Mailing Address - Fax:651-430-6527
Practice Address - Street 1:14949 62ND ST N
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-6132
Practice Address - Country:US
Practice Address - Phone:651-430-8344
Practice Address - Fax:651-430-6527
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-13
Last Update Date:2020-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC02297101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health