Provider Demographics
NPI:1568740397
Name:MURPHY, MARIE-ELAINA G (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:MARIE-ELAINA
Middle Name:G
Last Name:MURPHY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 KENTON AVE
Mailing Address - Street 2:
Mailing Address - City:RUMFORD
Mailing Address - State:RI
Mailing Address - Zip Code:02916-1319
Mailing Address - Country:US
Mailing Address - Phone:401-435-3733
Mailing Address - Fax:
Practice Address - Street 1:2 BRADFORD ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-1092
Practice Address - Country:US
Practice Address - Phone:401-865-6000
Practice Address - Fax:401-865-6001
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-27
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW011191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical