Basic Information
| Provider Information | |||||||||
| NPI: | 1124167671 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MORGAN | ||||||||
| FirstName: | WENDELL | ||||||||
| MiddleName: | SCOTT | ||||||||
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| Credential: | L.P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 344 | ||||||||
| Address2: | |||||||||
| City: | KINDER | ||||||||
| State: | LA | ||||||||
| PostalCode: | 706480344 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3377896150 | ||||||||
| FaxNumber: | 3376393008 | ||||||||
| Practice Location | |||||||||
| Address1: | 402 INDUSTRIAL DR | ||||||||
| Address2: | |||||||||
| City: | OBERLIN | ||||||||
| State: | LA | ||||||||
| PostalCode: | 706553519 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3376393001 | ||||||||
| FaxNumber: | 3376393008 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 3013 | LA | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.