Provider Demographics
NPI:1487199774
Name:MURPHY, PATRICK DECLAN (LCSW-R)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:DECLAN
Last Name:MURPHY
Suffix:
Gender:M
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 SHORE RD APT 5D
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-4261
Mailing Address - Country:US
Mailing Address - Phone:954-892-1389
Mailing Address - Fax:
Practice Address - Street 1:250 SHORE RD APT 5D
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-4261
Practice Address - Country:US
Practice Address - Phone:954-892-1389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-22
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR038891-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical