Provider Demographics
NPI:1043089931
Name:MURPHY, SHANEIKA LEVETTE (RBT)
Entity Type:Individual
Prefix:MRS
First Name:SHANEIKA
Middle Name:LEVETTE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 SOUTHLAND DR APT E3
Mailing Address - Street 2:
Mailing Address - City:BARNESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30204-1571
Mailing Address - Country:US
Mailing Address - Phone:678-544-9822
Mailing Address - Fax:
Practice Address - Street 1:201 SOUTHLAND DR APT E3
Practice Address - Street 2:
Practice Address - City:BARNESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30204-1571
Practice Address - Country:US
Practice Address - Phone:678-544-9822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA22241636106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician