Provider Demographics
NPI:1841625472
Name:MORGAN, JACQUELINE (LPC, NCC, CAADC)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:LPC, NCC, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1654
Mailing Address - Street 2:654 MAIN ST STE 6
Mailing Address - City:THOMSON
Mailing Address - State:GA
Mailing Address - Zip Code:30824-7422
Mailing Address - Country:US
Mailing Address - Phone:706-399-3332
Mailing Address - Fax:
Practice Address - Street 1:654 MAIN ST
Practice Address - Street 2:SUITE 6
Practice Address - City:THOMSON
Practice Address - State:GA
Practice Address - Zip Code:30824-7403
Practice Address - Country:US
Practice Address - Phone:706-399-3332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-13
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA325391101Y00000X
GAC0138101YA0400X
GALPC 00721101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)