Provider Demographics
NPI:1558118208
Name:NORTHCUTT, MORGAN ELAINE (LAC, EDS, SPS, NCSP)
Entity type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:ELAINE
Last Name:NORTHCUTT
Suffix:
Gender:F
Credentials:LAC, EDS, SPS, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2803 CREEK DR STE D
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-5377
Mailing Address - Country:US
Mailing Address - Phone:870-259-5638
Mailing Address - Fax:
Practice Address - Street 1:2803 CREEK DR STE D
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-5377
Practice Address - Country:US
Practice Address - Phone:870-259-5638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA2404011101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health