Provider Demographics
NPI:1306986435
Name:PEPPER, MORGAN DALE (LCSW)
Entity type:Individual
Prefix:MR
First Name:MORGAN
Middle Name:DALE
Last Name:PEPPER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 CLINTON ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4601
Mailing Address - Country:US
Mailing Address - Phone:718-930-9362
Mailing Address - Fax:
Practice Address - Street 1:157 CLINTON ST UNIT 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4601
Practice Address - Country:US
Practice Address - Phone:718-930-9362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR051284-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical