Provider Demographics
NPI:1689099541
Name:MURPHY, VERENA (PHD, LISW, LCSW-C)
Entity Type:Individual
Prefix:
First Name:VERENA
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:PHD, LISW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 GARDEN VIEW WAY
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6601
Mailing Address - Country:US
Mailing Address - Phone:330-714-4067
Mailing Address - Fax:
Practice Address - Street 1:714 GARDEN VIEW WAY
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6601
Practice Address - Country:US
Practice Address - Phone:330-714-4067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-28
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLI50077733104100000X
OHI1302293104100000X
MD197051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD19705OtherBOARD OF SOCIAL WORK EXAMINERS
DCLI50077733OtherBOARD OF SOCIAL WORK
OHI. 1302293OtherSTATE BOARD OF SOCIAL WORKERS