Individual provider Active NPI

Morgan Gray McGowan, PHD

  • Counselor
  • Fayetteville, AR
National Provider Identifier
1417333170
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
2013 N Green Acres Rd Ste C
Fayetteville, AR 72703-2600
Phone
(479) 477-2352
NPI assigned
Aug 5, 2015
Last updated
Mar 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU Primary

Addresses

Primary practice location

2013 N Green Acres Rd Ste C
Fayetteville, AR 72703-2600

Mailing address

PO Box 964
Fayetteville, AR 72702-0964
Phone (479) 477-2352

Other names 1

  • Tennie Morgan Gray Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Soul Purpose, LLC Counselor CurrentSince Jan 29, 2023 Accepting new patients

Locations

124 W Sunbridge Dr
Ste 5
Fayetteville, AR 72703
Phone (479) 900-2455

2013 N Green Acres Rd
Ste C
Fayetteville, AR 72703
Phone (479) 477-2352

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": "1438732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1417333170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 964",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727020964",
            "telephone_number": "479-477-2352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2013 N GREEN ACRES RD STE C",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727032600",
            "telephone_number": "479-477-2352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOWAN",
        "first_name": "MORGAN",
        "middle_name": "GRAY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-05",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TENNIE",
            "last_name": "GRAY",
            "middle_name": "MORGAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.