Provider Demographics
NPI:1952601734
Name:BAN-DRAOI, MORGAN (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:BAN-DRAOI
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:MA
Mailing Address - Zip Code:01364-1150
Mailing Address - Country:US
Mailing Address - Phone:401-742-5432
Mailing Address - Fax:
Practice Address - Street 1:131 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:MA
Practice Address - Zip Code:01364-1150
Practice Address - Country:US
Practice Address - Phone:401-742-5432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00487101YM0800X
MA7897101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health