Provider Demographics
NPI: | 1528524956 |
---|---|
Name: | YASMIN MORGAN LPC |
Entity type: | Organization |
Organization Name: | YASMIN MORGAN LPC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | YASMIN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MORGAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LPC |
Authorized Official - Phone: | 870-833-1088 |
Mailing Address - Street 1: | 4114 MCKNIGHT RD |
Mailing Address - Street 2: | |
Mailing Address - City: | TEXARKANA |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75503-1086 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 903-293-7093 |
Mailing Address - Fax: | 903-792-2235 |
Practice Address - Street 1: | 1806 N. SPRUCE ST |
Practice Address - Street 2: | |
Practice Address - City: | HOPE |
Practice Address - State: | AR |
Practice Address - Zip Code: | 71801 |
Practice Address - Country: | US |
Practice Address - Phone: | 870-833-1088 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-02-11 |
Last Update Date: | 2021-04-28 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Single Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
AR | 1336273549 | Other | NPI |