Provider Demographics
NPI:1396217253
Name:THE MURPHY WELLNESS RETREAT PLLC
Entity Type:Organization
Organization Name:THE MURPHY WELLNESS RETREAT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:DIORA
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:713-385-5528
Mailing Address - Street 1:1711 CAROLINE ST APT 203
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-8266
Mailing Address - Country:US
Mailing Address - Phone:713-385-5528
Mailing Address - Fax:
Practice Address - Street 1:1711 CAROLINE ST APT 203
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-8266
Practice Address - Country:US
Practice Address - Phone:713-385-5528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty