Individual provider Active NPI

Morgan Ellyse Dean, LCSW

  • Clinical Social Worker
  • Liberty, KY
National Provider Identifier
1679074645
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
252995 Issued in KY
Practice address
6295 E Ky 70
Liberty, KY 42539-6762
Phone
(844) 435-0900
Fax
(270) 858-4029
NPI assigned
Feb 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 252995 KY Primary

Addresses

Primary practice location

6295 E Ky 70
Liberty, KY 42539-6762

Mailing address

PO Box 1080
Burkesville, KY 42717-1080
Phone (270) 858-6655

Other identifiers 2

IdentifierTypeStateIssuer
14143680OtherCAQH
7100520070MedicaidKY

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1519603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1679074645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1080",
            "city": "BURKESVILLE",
            "state": "KY",
            "postal_code": "427171080",
            "telephone_number": "270-858-6655",
            "fax_number": "270-858-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6295 E KY 70",
            "city": "LIBERTY",
            "state": "KY",
            "postal_code": "425396762",
            "telephone_number": "844-435-0900",
            "fax_number": "270-858-4029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "MORGAN",
        "middle_name": "ELLYSE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-26",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "252995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14143680",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100520070",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.