Provider Demographics
NPI:1033256979
Name:MURPHY, KEVIN EDWARD (MA,CAGS)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:EDWARD
Last Name:MURPHY
Suffix:
Gender:M
Credentials:MA,CAGS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 D MILLLERS WAY
Mailing Address - Street 2:
Mailing Address - City:SUTTON
Mailing Address - State:MA
Mailing Address - Zip Code:01590
Mailing Address - Country:US
Mailing Address - Phone:508-767-3045
Mailing Address - Fax:508-453-2450
Practice Address - Street 1:335 CHANDLER ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01602-3441
Practice Address - Country:US
Practice Address - Phone:508-767-3045
Practice Address - Fax:508-453-2450
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3300101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health