Provider Demographics
NPI:1336649011
Name:MOLLY MURPHY COUNSELING
Entity Type:Organization
Organization Name:MOLLY MURPHY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:K
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:406-370-6696
Mailing Address - Street 1:4216 23RD AVE
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59803-1147
Mailing Address - Country:US
Mailing Address - Phone:406-370-6696
Mailing Address - Fax:
Practice Address - Street 1:1515 FAIRVIEW AVE STE 240
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-7821
Practice Address - Country:US
Practice Address - Phone:406-370-6696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-19
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
BBH-LCPC-LIC-17294101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty