Provider Demographics
NPI:1417904954
Name:MURPHY, JOHN (PSYD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:MURPHY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 CUMBERLAND ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-3323
Mailing Address - Country:US
Mailing Address - Phone:401-356-1940
Mailing Address - Fax:401-356-1949
Practice Address - Street 1:68 CUMBERLAND ST
Practice Address - Street 2:SUITE 102
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-3323
Practice Address - Country:US
Practice Address - Phone:401-356-1940
Practice Address - Fax:401-356-1949
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6994103TC0700X
RIPS00557103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI263971OtherBLUE CROSS BLUE SHIELD
RI406868OtherBLUE CHIP
RI470087OtherTUFT'S
RI6149083OtherUNITED HEALTH CARE
RIJM16434Medicaid