Provider Demographics
NPI:1700847381
Name:MURPH, REGINALD (LCSW CASAC)
Entity Type:Individual
Prefix:
First Name:REGINALD
Middle Name:
Last Name:MURPH
Suffix:
Gender:M
Credentials:LCSW CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 W 56TH ST
Mailing Address - Street 2:SUITE 18J
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-4321
Mailing Address - Country:US
Mailing Address - Phone:212-247-4347
Mailing Address - Fax:212-247-4347
Practice Address - Street 1:211 W 56TH ST
Practice Address - Street 2:SUITE 18J
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-4321
Practice Address - Country:US
Practice Address - Phone:212-247-4347
Practice Address - Fax:212-247-4347
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR039671-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYR039671-1OtherLCSW