Individual provider Active NPI

Clifford O Morgan Jr., PH.D

  • Clinical Psychologist
  • Los Lunas, NM
National Provider Identifier
1144345109
Registry record updated Mar 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
174 Issued in NM
Practice address
119 Telles St SW
Los Lunas, NM 87031-8518
Phone
(505) 865-7100
Fax
(505) 865-7100
NPI assigned
Mar 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 174 NM Primary

Addresses

Primary practice location

119 Telles St SW
Los Lunas, NM 87031-8518

Mailing address

119 Telles St SW
P.O. Boc 1757
Los Lunas, NM 87031-8518
Phone (505) 865-7100

Other identifiers 1

IdentifierTypeStateIssuer
N6200MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
174NMMDAthletic Trainer

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364342400000",
    "number": "1144345109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 TELLES ST SW",
            "address_2": "P.O. BOC 1757",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870318518",
            "telephone_number": "505-865-7100",
            "fax_number": "505-865-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 TELLES ST SW",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870318518",
            "telephone_number": "505-865-7100",
            "fax_number": "505-865-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORGAN",
        "first_name": "CLIFFORD",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2013-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NM",
            "license": "174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N6200",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Lunas, NM

Sources for this page

Verify at the official NPI Registry.