1427081645 NPI number — MRS. TINA J MURPHY LPC

Table of content: MRS. TINA J MURPHY LPC (NPI 1427081645)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427081645 NPI number — MRS. TINA J MURPHY LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MURPHY
Provider First Name:
TINA
Provider Middle Name:
J
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SPONHEIM
Provider Other First Name:
TINA
Provider Other Middle Name:
J
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1427081645
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/05/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
289 INDEPENDENCE BLVD
Provider Second Line Business Mailing Address:
STE 221
Provider Business Mailing Address City Name:
VIRGINIA BEACH
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23462
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-498-9320
Provider Business Mailing Address Fax Number:
757-498-9321

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
289 INDEPENDENCE BLVD
Provider Second Line Business Practice Location Address:
STE 221
Provider Business Practice Location Address City Name:
VIRGINIA BEACH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23462
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-498-9320
Provider Business Practice Location Address Fax Number:
757-498-9321
Provider Enumeration Date:
07/09/2006

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: 101YP2500X , with the licence number:  0701003915 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 269971 . This is a "COMPSYCH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 192240 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".




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