Provider Demographics
NPI:1952958191
Name:FEGEL, MORGAN (LMSW)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:FEGEL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:
Other - Last Name:APPLEBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:201 MONROE AVE NW STE 300
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2212
Mailing Address - Country:US
Mailing Address - Phone:616-328-6600
Mailing Address - Fax:
Practice Address - Street 1:2040 E BELTLINE AVE NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-9716
Practice Address - Country:US
Practice Address - Phone:616-328-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-22
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801105204104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker