Logan Kent Morgan

Individual provider Active NPI Community/Behavioral Health Agency · Maxwelton, WV

NPI 1740046754 · NPPES record last updated Feb 27, 2024

Key facts

NPI
1740046754
Entity type
Individual (NPI type 1)
Primary specialty
Community/Behavioral Health Agency 251S00000X
License
H2011 (WV)
Practice address
804 Industrial Park Rd
Maxwelton, WV 24957-8066
Phone
(304) 519-9180
NPI assigned
Feb 27, 2024
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
H2011WVMDPrevention Professional

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X H2011 WV Yes

Addresses

Primary practice location

804 Industrial Park Rd
Maxwelton, WV 24957-8066

Mailing address

804 Industrial Park Rd
Maxwelton, WV 24957-8066
Phone (304) 519-9180

Other providers in Maxwelton, WV

All providers in Maxwelton, WV · Community/Behavioral Health Agency in West Virginia

Sources for this page

Verify at the official NPI Registry.