Provider Demographics
NPI:1255521571
Name:MURPHY, VICKIE A (MSW, LSW, LICDC)
Entity type:Individual
Prefix:MS
First Name:VICKIE
Middle Name:A
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MSW, LSW, LICDC
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 222
Mailing Address - Street 2:8656 N. US ROUTE 68
Mailing Address - City:WEST LIBERTY
Mailing Address - State:OH
Mailing Address - Zip Code:43357-0222
Mailing Address - Country:US
Mailing Address - Phone:937-465-0366
Mailing Address - Fax:937-599-6233
Practice Address - Street 1:1400 S MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:BELLEFONTAINE
Practice Address - State:OH
Practice Address - Zip Code:43311-1581
Practice Address - Country:US
Practice Address - Phone:937-599-2662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-01
Last Update Date:2007-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH933610101YA0400X
OHS 00161441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical