Provider Demographics
NPI:1124466719
Name:GREEN, MORGAN (MA, CADC-I)
Entity type:Individual
Prefix:MS
First Name:MORGAN
Middle Name:
Last Name:GREEN
Suffix:
Gender:F
Credentials:MA, CADC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 52230
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89435-2230
Mailing Address - Country:US
Mailing Address - Phone:775-954-1400
Mailing Address - Fax:775-954-1406
Practice Address - Street 1:1725 S MCCARRAN BLVD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-9513
Practice Address - Country:US
Practice Address - Phone:775-954-1400
Practice Address - Fax:775-954-1406
Is Sole Proprietor?:No
Enumeration Date:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01039101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)