Provider Demographics
NPI:1457406209
Name:MURPHY, SUSAN D (LCPC, ACADC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:D
Last Name:MURPHY
Suffix:
Gender:F
Credentials:LCPC, ACADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6140 W EMERALD ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-8857
Mailing Address - Country:US
Mailing Address - Phone:208-367-6423
Mailing Address - Fax:208-367-3308
Practice Address - Street 1:6140 W EMERALD ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-8857
Practice Address - Country:US
Practice Address - Phone:208-367-6423
Practice Address - Fax:208-367-3308
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-4621101YM0800X
ID165101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)