Provider Demographics
NPI:1154973915
Name:SCOVILLE, MORGAN MARIE (MA)
Entity type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:MARIE
Last Name:SCOVILLE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:MORGAN
Other - Middle Name:MARIE SCOVILLE
Other - Last Name:LEMKE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:5317 S PALOUSE HWY APT E236
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-7802
Mailing Address - Country:US
Mailing Address - Phone:425-319-5159
Mailing Address - Fax:
Practice Address - Street 1:3157 E 17TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-5136
Practice Address - Country:US
Practice Address - Phone:509-838-8066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health