Provider Demographics
NPI:1083077556
Name:MURPHY, SHANNON (LPC)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 CLAIRMONT RD STE 203
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-1254
Mailing Address - Country:US
Mailing Address - Phone:678-698-2188
Mailing Address - Fax:
Practice Address - Street 1:2630 TALLEY ST UNIT 406
Practice Address - Street 2:DECATUR, GA 30030
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-5348
Practice Address - Country:US
Practice Address - Phone:678-698-2188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-01
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA008275101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional