Provider Demographics
NPI:1114386323
Name:VESTUTE, S MURPHY (MS, LMHC, CGRS)
Entity Type:Individual
Prefix:
First Name:S MURPHY
Middle Name:
Last Name:VESTUTE
Suffix:
Gender:F
Credentials:MS, LMHC, CGRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11362 162ND PL N
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33478-6143
Mailing Address - Country:US
Mailing Address - Phone:561-747-9513
Mailing Address - Fax:
Practice Address - Street 1:357 HIATT DR
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-8222
Practice Address - Country:US
Practice Address - Phone:562-529-4488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-16
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15825101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3600339300Medicaid