Provider Demographics
NPI:1093551863
Name:DONALDSON, MORGAN (LPC)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:DONALDSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 S BARBER AVE
Mailing Address - Street 2:
Mailing Address - City:POLO
Mailing Address - State:IL
Mailing Address - Zip Code:61064-1612
Mailing Address - Country:US
Mailing Address - Phone:815-677-1801
Mailing Address - Fax:
Practice Address - Street 1:402 2ND AVE
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:IL
Practice Address - Zip Code:61081-3699
Practice Address - Country:US
Practice Address - Phone:779-297-7016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.020275101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional