Provider Demographics
NPI:1245925569
Name:HASTINGS, MORGAN (LADC, LGSW)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:HASTINGS
Suffix:
Gender:F
Credentials:LADC, LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 34TH AVE S APT 407
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58104-7324
Mailing Address - Country:US
Mailing Address - Phone:218-234-8088
Mailing Address - Fax:
Practice Address - Street 1:819 30TH AVE S STE 206A
Practice Address - Street 2:
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56560-5054
Practice Address - Country:US
Practice Address - Phone:218-303-5560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-11
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN25361101YM0800X
MN305970101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)