Provider Demographics
NPI:1801292727
Name:LINDA DIANE MURPHY
Entity type:Organization
Organization Name:LINDA DIANE MURPHY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LCDC, NCC
Authorized Official - Phone:210-378-9104
Mailing Address - Street 1:6502 BANDERA RD
Mailing Address - Street 2:SUITE 200 F
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78238-1400
Mailing Address - Country:US
Mailing Address - Phone:210-928-7754
Mailing Address - Fax:
Practice Address - Street 1:6502 BANDERA RD
Practice Address - Street 2:SUITE 200F
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-1400
Practice Address - Country:US
Practice Address - Phone:210-928-7754
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9962101YA0400X
TX20127101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty