Provider Demographics
NPI:1770810392
Name:MURPHY, LETICIA ANTOINETTE (MFT, LADC)
Entity type:Individual
Prefix:
First Name:LETICIA
Middle Name:ANTOINETTE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MFT, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 VALLE VERDE COURT
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-2329
Mailing Address - Country:US
Mailing Address - Phone:702-454-2722
Mailing Address - Fax:702-454-2193
Practice Address - Street 1:711 VALLE VERDE COURT
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-2329
Practice Address - Country:US
Practice Address - Phone:702-454-2722
Practice Address - Fax:702-454-2193
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-04
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01258-L101YA0400X
NV01113106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)