Provider Demographics
NPI:1710114525
Name:MURPHY RAE, PATRICIA C (LCSW)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:C
Last Name:MURPHY RAE
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 1:204 STOCKTON DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-2224
Mailing Address - Country:US
Mailing Address - Phone:817-723-7100
Mailing Address - Fax:817-491-8661
Practice Address - Street 1:204 STOCKTON DR
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-2224
Practice Address - Country:US
Practice Address - Phone:817-723-7100
Practice Address - Fax:817-491-8661
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX336841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical