Provider Demographics
NPI:1932782547
Name:MATTHEWS, MORGAN PHILLIPS (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:PHILLIPS
Last Name:MATTHEWS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4859 SHED RD STE 500
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-5493
Mailing Address - Country:US
Mailing Address - Phone:318-747-6977
Mailing Address - Fax:318-747-6971
Practice Address - Street 1:4859 SHED RD STE 500
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-5493
Practice Address - Country:US
Practice Address - Phone:318-747-6977
Practice Address - Fax:318-747-6971
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-30
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7900101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health