Provider Demographics
NPI:1902573983
Name:MURTAGH, SHELBY (A-LMFT)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:MURTAGH
Suffix:
Gender:F
Credentials:A-LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 E MARSHALL ST
Mailing Address - Street 2:
Mailing Address - City:TOLONO
Mailing Address - State:IL
Mailing Address - Zip Code:61880-9549
Mailing Address - Country:US
Mailing Address - Phone:217-731-4638
Mailing Address - Fax:
Practice Address - Street 1:206 N RANDOLPH ST
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61820-3949
Practice Address - Country:US
Practice Address - Phone:217-731-4638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist