Provider Demographics
NPI:1144876798
Name:MORGAN, MARILYN TAYLOR (LCSW)
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:TAYLOR
Last Name:MORGAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1765 N 1550 E
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-5710
Mailing Address - Country:US
Mailing Address - Phone:801-380-6980
Mailing Address - Fax:
Practice Address - Street 1:1765 N 1550 E
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-5710
Practice Address - Country:US
Practice Address - Phone:801-380-6980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-09
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT261835-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical