Provider Demographics
NPI:1477653640
Name:MORGAN, GERALDINE E (LCSW)
Entity type:Individual
Prefix:MS
First Name:GERALDINE
Middle Name:E
Last Name:MORGAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 51521
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-0312
Mailing Address - Country:US
Mailing Address - Phone:941-549-0221
Mailing Address - Fax:
Practice Address - Street 1:950 S TAMIAMI TRL STE 202
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-7818
Practice Address - Country:US
Practice Address - Phone:941-549-0221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW14111314000000X, 310400000X, 311Z00000X, 313M00000X
FLSW 141111041C0700X
PACW0173371041C0700X
NJ44SC055490001041C0700X, 310400000X, 311500000X, 311Z00000X, 313M00000X, 314000000X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing FacilityGroup - Single Specialty
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA357846Medicare UPIN
NJ345147DSMMedicare UPIN