Provider Demographics
NPI:1306971783
Name:LONDON, MORGAN Z (LMHC)
Entity type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:Z
Last Name:LONDON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 MONUMENT RD
Mailing Address - Street 2:#53
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-6489
Mailing Address - Country:US
Mailing Address - Phone:904-229-8013
Mailing Address - Fax:
Practice Address - Street 1:13474 ATLANTIC BLVD
Practice Address - Street 2:STE 106
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-0101
Practice Address - Country:US
Practice Address - Phone:904-229-8013
Practice Address - Fax:904-220-2098
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2008-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
FLMH9580101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH9580OtherDEPARTMENT OF HEALTH