Provider Demographics
NPI:1144518135
Name:BRUCE, MORGAN SUZANNE (LMSW)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:SUZANNE
Last Name:BRUCE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:SUZANNE
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:1044 NORTHWEST BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-2114
Mailing Address - Country:US
Mailing Address - Phone:208-930-1740
Mailing Address - Fax:
Practice Address - Street 1:1044 NORTHWEST BLVD STE C
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2114
Practice Address - Country:US
Practice Address - Phone:208-930-1740
Practice Address - Fax:208-930-1695
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-12
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-31444101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health