Provider Demographics
NPI:1396514360
Name:HEAD, JOHN MORGAN
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:MORGAN
Last Name:HEAD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 2ND ST NW # 87102
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-2218
Mailing Address - Country:US
Mailing Address - Phone:505-273-8750
Mailing Address - Fax:
Practice Address - Street 1:1120 2ND ST NW # 87102
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-2218
Practice Address - Country:US
Practice Address - Phone:505-273-8750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-01
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker