Provider Demographics
NPI:1710008420
Name:MURPHY, ELLEN MARIA (LCSW)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:MARIA
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 1:402 TALAHI RD SE
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-5869
Mailing Address - Country:US
Mailing Address - Phone:202-957-0023
Mailing Address - Fax:
Practice Address - Street 1:133 PARK ST. SE
Practice Address - Street 2:THE WOMEN'S CENTER
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-5869
Practice Address - Country:US
Practice Address - Phone:703-938-6907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040065211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical