Provider Demographics
NPI:1356691786
Name:MORGAN, THOMAS J (EDD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:J
Last Name:MORGAN
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 ARBEGAST DRIVE
Mailing Address - Street 2:
Mailing Address - City:BRIGANTINE
Mailing Address - State:NJ
Mailing Address - Zip Code:08203
Mailing Address - Country:US
Mailing Address - Phone:609-760-9247
Mailing Address - Fax:
Practice Address - Street 1:306 ARBEGAST DRIVE
Practice Address - Street 2:
Practice Address - City:BRIGANTINE
Practice Address - State:NJ
Practice Address - Zip Code:08203
Practice Address - Country:US
Practice Address - Phone:609-760-9247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100366200103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool