Provider Demographics
NPI:1184065666
Name:MURPHY, JENNIFER L (LPC-MHSP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:L
Last Name:MURPHY
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 E BOCKMAN WAY RM 205
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:TN
Mailing Address - Zip Code:38583-2034
Mailing Address - Country:US
Mailing Address - Phone:931-510-0261
Mailing Address - Fax:
Practice Address - Street 1:1 E BOCKMAN WAY RM 205
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:TN
Practice Address - Zip Code:38583-2034
Practice Address - Country:US
Practice Address - Phone:931-510-0261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-11
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000002926101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN12567827OtherCAQH