Provider Demographics
NPI:1457344798
Name:MORGAN, J RICHARD (LCSW-R)
Entity Type:Individual
Prefix:MR
First Name:J
Middle Name:RICHARD
Last Name:MORGAN
Suffix:
Gender:M
Credentials:LCSW-R
Other - Prefix:MR
Other - First Name:JAMES
Other - Middle Name:RICHARD
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW-R
Mailing Address - Street 1:402 UNION ST
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12305-1119
Mailing Address - Country:US
Mailing Address - Phone:518-374-7555
Mailing Address - Fax:518-374-6898
Practice Address - Street 1:196 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-1227
Practice Address - Country:US
Practice Address - Phone:518-439-0033
Practice Address - Fax:518-439-7167
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR049373-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02121882Medicaid
NY02121882Medicaid
NYBB3978Medicare PIN