Provider Demographics
NPI:1811904030
Name:MURPHY, NANCY (MA)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 E WASHINGTON ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:EAST PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61611-2667
Mailing Address - Country:US
Mailing Address - Phone:309-251-0318
Mailing Address - Fax:309-689-0774
Practice Address - Street 1:422 E WASHINGTON ST
Practice Address - Street 2:SUITE 100
Practice Address - City:EAST PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61611-2667
Practice Address - Country:US
Practice Address - Phone:309-251-0318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional