Morgan Provo, is a
Behavior Technician based in Brookfield, Wisconsin. Morgan Provo is licensed to practice in * (Not Available) (license number ) and her current practice location is
13100 W Lisbon Rd Ste 600, Brookfield, Wisconsin. She can be reached at her office (for appointments etc.) via phone at
(833) 646-3222.
NPI number for Morgan Provo is 1457046807 and her current mailing address is 224 W 35th St Ste 500, New York, New York. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1457046807.
Healthcare Provider's Profile
| Full Name | Morgan Provo |
|---|
| Gender | Female |
|---|
| Speciality | Behavior Technician |
|---|
| Location | 13100 W Lisbon Rd Ste 600, Brookfield, Wisconsin |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1457046807
- Provider Enumeration Date: 04/10/2023
- Last Update Date: 09/22/2025
Medical Identifiers
Medical identifiers for Morgan Provo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1457046807 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (Wisconsin) | Secondary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Morgan Provo is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Morgan Provo,
224 W 35th St Ste 500,
New York, NY 10001-2538
Ph: (833) 646-3222 | Morgan Provo,
13100 W Lisbon Rd Ste 600,
Brookfield, WI 53005-2509
Ph: (833) 646-3222 |
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