Provider Demographics
NPI:1356134340
Name:PSIMER, MORGAN MCGLONE
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:MCGLONE
Last Name:PSIMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5087 STATE HIGHWAY 955
Mailing Address - Street 2:
Mailing Address - City:OLIVE HILL
Mailing Address - State:KY
Mailing Address - Zip Code:41164-8876
Mailing Address - Country:US
Mailing Address - Phone:606-316-2720
Mailing Address - Fax:
Practice Address - Street 1:5087 STATE HIGHWAY 955
Practice Address - Street 2:
Practice Address - City:OLIVE HILL
Practice Address - State:KY
Practice Address - Zip Code:41164-8876
Practice Address - Country:US
Practice Address - Phone:606-316-2720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-23
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency