Provider Demographics
NPI:1881192201
Name:MORGAN, JOHN (CASAC)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:MORGAN
Suffix:
Gender:M
Credentials:CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5945 SHORE PKWY APT 8A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-5726
Mailing Address - Country:US
Mailing Address - Phone:917-756-5979
Mailing Address - Fax:
Practice Address - Street 1:5945 SHORE PKWY APT 8A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-5726
Practice Address - Country:US
Practice Address - Phone:917-756-5979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-31
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)