Provider Demographics
NPI:1619147600
Name:MURPHY, COLLEEN I (LCSW)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:I
Last Name:MURPHY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 S EWING ST STE 200
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-5732
Mailing Address - Country:US
Mailing Address - Phone:406-465-8531
Mailing Address - Fax:
Practice Address - Street 1:25 S EWING ST STE 200
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-5732
Practice Address - Country:US
Practice Address - Phone:406-446-5853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-05
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT4901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0255892Medicaid