Provider Demographics
NPI:1538641246
Name:MURPHY, MEGAN KERRIE
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:KERRIE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 FRANCK AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-2547
Mailing Address - Country:US
Mailing Address - Phone:908-642-0992
Mailing Address - Fax:
Practice Address - Street 1:314 FRANCK AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206-2547
Practice Address - Country:US
Practice Address - Phone:908-642-0992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39002951A101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional