Provider Demographics
NPI:1508598103
Name:MORGAN ROGLIANO, LICSW, LLC
Entity Type:Organization
Organization Name:MORGAN ROGLIANO, LICSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGLIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-229-2559
Mailing Address - Street 1:18 STEPHAN AVE
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01832-3410
Mailing Address - Country:US
Mailing Address - Phone:303-229-2559
Mailing Address - Fax:
Practice Address - Street 1:175
Practice Address - Street 2:DERBY ST
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-0204
Practice Address - Country:US
Practice Address - Phone:508-630-6892
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)