Provider Demographics
NPI:1306432323
Name:BOLING, MORGAN (LSWAIC)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:BOLING
Suffix:
Gender:F
Credentials:LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5108 196TH ST SW STE 350
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-6169
Mailing Address - Country:US
Mailing Address - Phone:425-582-2041
Mailing Address - Fax:425-527-0468
Practice Address - Street 1:5108 196TH ST SW STE 350
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-6169
Practice Address - Country:US
Practice Address - Phone:425-582-2041
Practice Address - Fax:425-527-0468
Is Sole Proprietor?:No
Enumeration Date:2020-12-14
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X, 390200000X
WASC61439439101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program