Provider Demographics
NPI:1669238168
Name:WOODWARD, MORGAN LANE (LMHCA)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:LANE
Last Name:WOODWARD
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:LANE
Other - Last Name:WOODSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2856 NE 183RD ST
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST PARK
Mailing Address - State:WA
Mailing Address - Zip Code:98155-4029
Mailing Address - Country:US
Mailing Address - Phone:650-448-5653
Mailing Address - Fax:
Practice Address - Street 1:2856 NE 183RD ST
Practice Address - Street 2:
Practice Address - City:LAKE FOREST PARK
Practice Address - State:WA
Practice Address - Zip Code:98155-4029
Practice Address - Country:US
Practice Address - Phone:650-448-5653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-23
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61525999106H00000X
WA61525992101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist