Provider Demographics
NPI:1801636402
Name:DUFFY, MORGAN ELAINE
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:ELAINE
Last Name:DUFFY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 7TH ST
Mailing Address - Street 2:
Mailing Address - City:BLACKSTONE
Mailing Address - State:VA
Mailing Address - Zip Code:23824-2408
Mailing Address - Country:US
Mailing Address - Phone:434-480-6355
Mailing Address - Fax:
Practice Address - Street 1:408 7TH ST
Practice Address - Street 2:
Practice Address - City:BLACKSTONE
Practice Address - State:VA
Practice Address - Zip Code:23824-2408
Practice Address - Country:US
Practice Address - Phone:434-480-6355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-30
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAT67576024OtherDRIVER'S LICENSE