Provider Demographics
NPI:1750774089
Name:MURPHY, ASHLEY KEAY (LICSW)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:KEAY
Last Name:MURPHY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 PENNSYLAVNIA AVENUE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25302
Mailing Address - Country:US
Mailing Address - Phone:304-388-2545
Mailing Address - Fax:304-388-2781
Practice Address - Street 1:800 PENNSYLAVNIA AVENUE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25302
Practice Address - Country:US
Practice Address - Phone:304-388-2545
Practice Address - Fax:304-388-2781
Is Sole Proprietor?:No
Enumeration Date:2015-03-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVDP009445811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0005355002Medicaid
WV9122432Medicare UPIN