Provider Demographics
NPI:1689164543
Name:MURPHY, ELIZABETH (LABA, BCABA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:LABA, BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 STRADER DR STE 150
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40505-4090
Mailing Address - Country:US
Mailing Address - Phone:859-899-9200
Mailing Address - Fax:859-899-9202
Practice Address - Street 1:1035 STRADER DR STE 150
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40505
Practice Address - Country:US
Practice Address - Phone:859-899-9200
Practice Address - Fax:859-899-9202
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-16
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0-18-8574106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst