Provider Demographics
NPI:1770806598
Name:NORTH, MORGAN (MED)
Entity type:Individual
Prefix:MS
First Name:MORGAN
Middle Name:
Last Name:NORTH
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9834 MOORINGS DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-7596
Mailing Address - Country:US
Mailing Address - Phone:904-268-9380
Mailing Address - Fax:904-268-9380
Practice Address - Street 1:9834 MOORINGS DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-7596
Practice Address - Country:US
Practice Address - Phone:904-268-9380
Practice Address - Fax:904-268-9380
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH-3487101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor