Provider Demographics
NPI:1043295850
Name:MURPHY, ANNEMARIE THERESA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANNEMARIE
Middle Name:THERESA
Last Name:MURPHY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:22 WOODCREST LN
Mailing Address - Street 2:UNIT 22
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-7143
Mailing Address - Country:US
Mailing Address - Phone:203-459-0515
Mailing Address - Fax:203-336-6525
Practice Address - Street 1:1057 BROAD STREET
Practice Address - Street 2:SUITE 304
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06604-4219
Practice Address - Country:US
Practice Address - Phone:203-895-0311
Practice Address - Fax:203-366-6525
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-14
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001992103TC0700X, 103T00000X
CT01992103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT680001388OtherMEDICARE
CT004142907Medicaid