Provider Demographics
NPI:1316340920
Name:MORGAN, NICOLE D (PSYD)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:D
Last Name:MORGAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:754 WARRENTON RD
Mailing Address - Street 2:SUITE 113-229
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22406-1098
Mailing Address - Country:US
Mailing Address - Phone:540-395-4565
Mailing Address - Fax:
Practice Address - Street 1:8134 OLD KEENE MILL RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22152-1800
Practice Address - Country:US
Practice Address - Phone:703-569-8736
Practice Address - Fax:703-569-7248
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810005080103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical