Provider Demographics
NPI:1962118331
Name:STONG, MORGAN JO
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:JO
Last Name:STONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1298 APPLE LN
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34608-5212
Mailing Address - Country:US
Mailing Address - Phone:231-286-6322
Mailing Address - Fax:
Practice Address - Street 1:1298 APPLE LN
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608-5212
Practice Address - Country:US
Practice Address - Phone:231-286-6322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT137372106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist