Provider Demographics
NPI:1790318681
Name:MURPHY, TAMIKO CROMARTIE (C ADC, LCAS-A)
Entity Type:Individual
Prefix:MS
First Name:TAMIKO
Middle Name:CROMARTIE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:C ADC, LCAS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2686
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28359-2686
Mailing Address - Country:US
Mailing Address - Phone:910-618-6024
Mailing Address - Fax:
Practice Address - Street 1:2501 E ELIZABETHTOWN RD
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-3225
Practice Address - Country:US
Practice Address - Phone:910-738-7880
Practice Address - Fax:910-738-7882
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-19
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCADC-21311101Y00000X, 101YA0400X
NCLCAS-A-24014101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor