Provider Demographics
NPI:1578176186
Name:MURPHY, ELLEN VIRGINIA (CARC)
Entity Type:Individual
Prefix:MISS
First Name:ELLEN
Middle Name:VIRGINIA
Last Name:MURPHY
Suffix:
Gender:F
Credentials:CARC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 MAIN STREET
Mailing Address - Street 2:APT # O-201
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845
Mailing Address - Country:US
Mailing Address - Phone:978-907-3639
Mailing Address - Fax:
Practice Address - Street 1:360 MERRIMACK ST BLDG J3
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-1740
Practice Address - Country:US
Practice Address - Phone:978-771-1433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)