Provider Demographics
NPI:1376513747
Name:MURPHY, KATHLEEN S (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:S
Last Name:MURPHY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 WALL ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-4758
Mailing Address - Country:US
Mailing Address - Phone:781-221-2774
Mailing Address - Fax:617-421-2699
Practice Address - Street 1:20 WALL ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-4758
Practice Address - Country:US
Practice Address - Phone:781-221-2774
Practice Address - Fax:617-421-2699
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2491235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0081267OtherNEIGHBORHOOD HEALTH PLAN
MASPOO82OtherBLUE CROSS
MA0389501Medicaid
MAHV0002OtherHARVARD PILGRIM
MAB501027OtherCIGNA