Provider Demographics
NPI:1740001213
Name:BOGGESS MCCOY, MORGAN BAILEE (CSW)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:BAILEE
Last Name:BOGGESS MCCOY
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 JACKSBORO RD
Mailing Address - Street 2:
Mailing Address - City:BRONSTON
Mailing Address - State:KY
Mailing Address - Zip Code:42518-9654
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:212 JACKSBORO RD
Practice Address - Street 2:
Practice Address - City:BRONSTON
Practice Address - State:KY
Practice Address - Zip Code:42518-9654
Practice Address - Country:US
Practice Address - Phone:606-278-2499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2597301041C0700X
KY2566071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical