Provider Demographics
NPI:1003214289
Name:MURPHY, REGAN (MA, LCSW)
Entity Type:Individual
Prefix:MS
First Name:REGAN
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MA, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 N WINCHESTER AVE
Mailing Address - Street 2:APT. 2
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-3766
Mailing Address - Country:US
Mailing Address - Phone:773-294-2136
Mailing Address - Fax:
Practice Address - Street 1:4753 N BROADWAY ST STE 900
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-7908
Practice Address - Country:US
Practice Address - Phone:847-979-0041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-19
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0188151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical