Provider Demographics
NPI:1831712348
Name:MORGAN, BLAINA GABRIELLE (LMSW)
Entity type:Individual
Prefix:
First Name:BLAINA
Middle Name:GABRIELLE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37461 CREEKVIEW LN
Mailing Address - Street 2:
Mailing Address - City:NEW BALTIMORE
Mailing Address - State:MI
Mailing Address - Zip Code:48047-6398
Mailing Address - Country:US
Mailing Address - Phone:586-914-0342
Mailing Address - Fax:
Practice Address - Street 1:37461 CREEKVIEW LN
Practice Address - Street 2:
Practice Address - City:NEW BALTIMORE
Practice Address - State:MI
Practice Address - Zip Code:48047-6398
Practice Address - Country:US
Practice Address - Phone:586-914-0342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-19
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011069461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical