Basic Information
Provider Information
NPI: 1073147351
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BUCKNER
FirstName: MORGAN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LCMHC ASSOCIATE
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 HOSPITAL RD
Address2: CALLER BOX C-268
City: CHEROKEE
State: NC
PostalCode: 28719
CountryCode: US
TelephoneNumber: 8284979163
FaxNumber:  
Practice Location
Address1: 375 SEQUOYAH TRL
Address2:  
City: CHEROKEE
State: NC
PostalCode: 28719
CountryCode: US
TelephoneNumber: 8284979163
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/26/2020
LastUpdateDate: 02/26/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/26/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500XA14831NCY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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