Provider Demographics
NPI:1508595356
Name:MURPHY, LINDSAY JEAN (CO 61279433)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:JEAN
Last Name:MURPHY
Suffix:
Gender:F
Credentials:CO 61279433
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19045 WA-305
Mailing Address - Street 2:SUITE 190
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370
Mailing Address - Country:US
Mailing Address - Phone:360-598-3929
Mailing Address - Fax:
Practice Address - Street 1:19045 WA-305
Practice Address - Street 2:SUITE 190
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370
Practice Address - Country:US
Practice Address - Phone:360-598-3929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACO61279433101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)