Provider Demographics
NPI:1497145528
Name:MURPHY, BRYANT (LADC-S, LCPC)
Entity Type:Individual
Prefix:
First Name:BRYANT
Middle Name:
Last Name:MURPHY
Suffix:
Gender:M
Credentials:LADC-S, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8414 FARM RD STE 180377
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-8170
Mailing Address - Country:US
Mailing Address - Phone:702-469-2061
Mailing Address - Fax:866-611-8528
Practice Address - Street 1:5785 CENTENNIAL CENTER BLVD STE 240
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-7108
Practice Address - Country:US
Practice Address - Phone:702-469-2061
Practice Address - Fax:866-611-8528
Is Sole Proprietor?:No
Enumeration Date:2015-01-27
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01685L101YA0400X
101YM0800X
NVCI0341101YP2500X
NVCP1289101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV01685-LOtherLICENSE