Provider Demographics
NPI:1881065811
Name:FITZGERALD, MORGAN TAYLOR (LPC)
Entity type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:TAYLOR
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:MORGAN
Other - Middle Name:TAYLOR
Other - Last Name:FITZGERALD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1616 E 19TH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-6674
Mailing Address - Country:US
Mailing Address - Phone:405-696-6623
Mailing Address - Fax:
Practice Address - Street 1:1616 E 19TH ST STE 103
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-6674
Practice Address - Country:US
Practice Address - Phone:405-696-6623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-16
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77578101YM0800X
101YM0800X
OK10564101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health