Provider Demographics
NPI:1841481207
Name:MORGAN DOB 1/7/33, ANNE LY (MSW LCSW)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:LY
Last Name:MORGAN DOB 1/7/33
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:358 NC HIGHWAY 45 S
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:NC
Mailing Address - Zip Code:27962-9242
Mailing Address - Country:US
Mailing Address - Phone:252-217-4049
Mailing Address - Fax:
Practice Address - Street 1:358 NC HIGHWAY 45 S
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:NC
Practice Address - Zip Code:27962-9242
Practice Address - Country:US
Practice Address - Phone:252-217-4049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-09
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0057171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6106795Medicaid
NC2852236Medicare PIN