Provider Demographics
NPI:1942425848
Name:MURPHY, MICHAEL JAMES (LCSW, BCD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JAMES
Last Name:MURPHY
Suffix:
Gender:M
Credentials:LCSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 E MARTHART AVE
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-2411
Mailing Address - Country:US
Mailing Address - Phone:610-789-6396
Mailing Address - Fax:
Practice Address - Street 1:105 SIBLEY AVE
Practice Address - Street 2:HAMILTON MIRAGLIA ASSO
Practice Address - City:ARDMORE
Practice Address - State:PA
Practice Address - Zip Code:19003-2311
Practice Address - Country:US
Practice Address - Phone:610-896-8379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0138931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA086139Medicare ID - Type Unspecified