Provider Demographics
NPI:1407150964
Name:MURPHY, KRYSTAL LEIGH (LCAS, MA)
Entity Type:Individual
Prefix:MRS
First Name:KRYSTAL
Middle Name:LEIGH
Last Name:MURPHY
Suffix:
Gender:F
Credentials:LCAS, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3110 ARENDELL ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-6511
Mailing Address - Country:US
Mailing Address - Phone:252-727-5488
Mailing Address - Fax:252-727-5302
Practice Address - Street 1:3110 ARENDELL ST
Practice Address - Street 2:SUITE 4
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-6511
Practice Address - Country:US
Practice Address - Phone:252-727-5488
Practice Address - Fax:252-727-5302
Is Sole Proprietor?:No
Enumeration Date:2010-12-27
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1855101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1855OtherLICENSED CLINICAL ADDICTION SPECIALIST