Provider Demographics
NPI:1932475332
Name:MURPHY, THASHA SHRESE (LLMSW)
Entity Type:Individual
Prefix:MRS
First Name:THASHA
Middle Name:SHRESE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23700 POND RD APT 101
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3139
Mailing Address - Country:US
Mailing Address - Phone:313-675-2263
Mailing Address - Fax:313-852-2000
Practice Address - Street 1:23700 POND RD APT 101
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-3139
Practice Address - Country:US
Practice Address - Phone:313-675-2263
Practice Address - Fax:313-852-2000
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-29
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801093925104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker