Provider Demographics
NPI:1487709192
Name:MORGAN, LORI A (LCSW-R)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:A
Last Name:MORGAN
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:A
Other - Last Name:MONK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-R
Mailing Address - Street 1:1062 STATE ROUTE 38
Mailing Address - Street 2:PO BOX 177
Mailing Address - City:OWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13827-3209
Mailing Address - Country:US
Mailing Address - Phone:607-687-4000
Mailing Address - Fax:607-687-6396
Practice Address - Street 1:1062 STATE ROUTE 38
Practice Address - Street 2:
Practice Address - City:OWEGO
Practice Address - State:NY
Practice Address - Zip Code:13827
Practice Address - Country:US
Practice Address - Phone:607-687-4000
Practice Address - Fax:607-687-6396
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070844-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY070844-1OtherLCSW LICENSE NUMBER
NM00618162Medicaid
P76119Medicare UPIN
NY070844-1OtherLCSW LICENSE NUMBER
NY39062AMedicare ID - Type UnspecifiedEMPLOYER MEDICARE NUMBER