Provider Demographics
NPI:1669661682
Name:MURPHY-MANCINI AND ASSOCIATES, ELEN A (LICSW PHD)
Entity Type:Individual
Prefix:DR
First Name:ELEN
Middle Name:A
Last Name:MURPHY-MANCINI AND ASSOCIATES
Suffix:
Gender:F
Credentials:LICSW PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 CAREW ST
Mailing Address - Street 2:SUITE 315
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104-2301
Mailing Address - Country:US
Mailing Address - Phone:413-732-2060
Mailing Address - Fax:413-599-0097
Practice Address - Street 1:299 CAREW ST
Practice Address - Street 2:SUITE 315
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-2301
Practice Address - Country:US
Practice Address - Phone:413-732-2060
Practice Address - Fax:413-599-0097
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-16
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1044911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP22055Medicare PIN