Provider Demographics
NPI:1316378573
Name:MURPHY, KELLY
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:
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 347
Mailing Address - Street 2:
Mailing Address - City:ALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08001-0347
Mailing Address - Country:US
Mailing Address - Phone:856-369-6320
Mailing Address - Fax:
Practice Address - Street 1:72 E CANAL ST
Practice Address - Street 2:
Practice Address - City:ALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08001-2038
Practice Address - Country:US
Practice Address - Phone:856-369-6320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-12
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1041C0700X
NJ44SC055444001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical