Provider Demographics
NPI:1598305302
Name:WALLBROWN, MORGAN (LPCC)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:WALLBROWN
Suffix:
Gender:
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9215 MENTOR AVE # 1020
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-6477
Mailing Address - Country:US
Mailing Address - Phone:440-289-2287
Mailing Address - Fax:
Practice Address - Street 1:5999B HALLE FARM DR
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-3072
Practice Address - Country:US
Practice Address - Phone:216-220-7495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-09
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1801381-TRNE101YM0800X
OHC.2002767101YP2500X
OHE.2303911101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional