Provider Demographics
NPI:1316424963
Name:OVERSTREET, MORGAN KIAH (LLPC)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:KIAH
Last Name:OVERSTREET
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:MRS
Other - First Name:MORGAN
Other - Middle Name:KIAH
Other - Last Name:HOSKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6549 TOWN CENTER DR STE A
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-4824
Mailing Address - Country:US
Mailing Address - Phone:248-620-6400
Mailing Address - Fax:
Practice Address - Street 1:5955 W MAIN ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-8700
Practice Address - Country:US
Practice Address - Phone:269-205-6339
Practice Address - Fax:269-353-2960
Is Sole Proprietor?:No
Enumeration Date:2018-07-26
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401016713101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor