Provider Demographics
NPI:1790707099
Name:MURPHY, LORI J (LCSW-R)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:J
Last Name:MURPHY
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-2518
Mailing Address - Country:US
Mailing Address - Phone:315-343-8000
Mailing Address - Fax:315-343-2203
Practice Address - Street 1:154 W 7TH ST
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-2518
Practice Address - Country:US
Practice Address - Phone:315-343-8000
Practice Address - Fax:315-343-2203
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR037135-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01747300Medicaid
NYJ300081365Medicare PIN