Provider Demographics
NPI:1265476956
Name:MURPHY, GWEN (LPC)
Entity Type:Individual
Prefix:
First Name:GWEN
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 1:12 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-4136
Mailing Address - Country:US
Mailing Address - Phone:806-468-7847
Mailing Address - Fax:806-356-0590
Practice Address - Street 1:12 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-4136
Practice Address - Country:US
Practice Address - Phone:806-468-7847
Practice Address - Fax:806-356-0590
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10637101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3272LCOtherBLUE CROSS/BLUE SHIELD
TX2047175OtherCIGNA BEHAVIORAL HEALTH
TX209651OtherVALUE OPTIONS
TX7962134OtherAETNA