Provider Demographics
NPI:1053959601
Name:MORGAN, MCKENZIE (LCSW)
Entity type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:377 E RIVERSIDE DR
Mailing Address - Street 2:BLDG B
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-8013
Mailing Address - Country:US
Mailing Address - Phone:435-229-9511
Mailing Address - Fax:
Practice Address - Street 1:377 E RIVERSIDE DR
Practice Address - Street 2:BLDG B
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-8013
Practice Address - Country:US
Practice Address - Phone:435-229-9511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-13
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11435466-3502101Y00000X
UT11435466-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor