Provider Demographics
NPI:1104857630
Name:GREENE MURPHY, IRENE (LCSW,LADC)
Entity Type:Individual
Prefix:MS
First Name:IRENE
Middle Name:
Last Name:GREENE MURPHY
Suffix:
Gender:F
Credentials:LCSW,LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 368
Mailing Address - Street 2:
Mailing Address - City:SEAL COVE
Mailing Address - State:ME
Mailing Address - Zip Code:04674-0368
Mailing Address - Country:US
Mailing Address - Phone:207-460-6605
Mailing Address - Fax:
Practice Address - Street 1:KIMBALL ROAD
Practice Address - Street 2:MT DESERT MEDICAL CENTER
Practice Address - City:NORTHEAST HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04662
Practice Address - Country:US
Practice Address - Phone:207-460-6605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC1815101YA0400X
MELC6595101YM0800X
FLSW2698101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health