1760542971 NPI number — KARLA E MORSE L.P.C., A.C.S.

Table of content: KARLA E MORSE L.P.C., A.C.S. (NPI 1760542971)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760542971 NPI number — KARLA E MORSE L.P.C., A.C.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORSE
Provider First Name:
KARLA
Provider Middle Name:
E
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
L.P.C., A.C.S.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BLACK
Provider Other First Name:
KARLA
Provider Other Middle Name:
E
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.A., N.C.C., L.P.C.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1760542971
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/13/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
25 WATERVIEW CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARLTON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08053-3724
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-906-0662
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
25 WATERVIEW CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARLTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08053-3724
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-906-0662
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  37PC00320500 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2745511000 . This is a "INDEPENDENCE BLUE CROSS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2745511000 . This is a "AMERIHEALTH PPO PROV NUMB" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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