1346299195 NPI number — MS. MARY MURPHY MA LMFT

Table of content: MS. MARY MURPHY MA LMFT (NPI 1346299195)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346299195 NPI number — MS. MARY MURPHY MA LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MURPHY
Provider First Name:
MARY
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MA LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COGHILL
Provider Other First Name:
MARY
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1346299195
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
965 LIBERTY ST SE
Provider Second Line Business Mailing Address:
POYAMA COUNSELING SERVICES
Provider Business Mailing Address City Name:
SALEM
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97302
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-588-2004
Provider Business Mailing Address Fax Number:
503-588-2415

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
965 LIBERTY ST SE
Provider Second Line Business Practice Location Address:
POYAMA COUNSELING SERVICES
Provider Business Practice Location Address City Name:
SALEM
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-588-2004
Provider Business Practice Location Address Fax Number:
503-588-2415
Provider Enumeration Date:
05/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  T0288 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 042577 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".




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