Provider Demographics
NPI:1134558141
Name:MURPHY, PATRICK JOHN (LMSW)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:JOHN
Last Name:MURPHY
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6270 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:MI
Mailing Address - Zip Code:49111-9480
Mailing Address - Country:US
Mailing Address - Phone:855-869-6900
Mailing Address - Fax:269-927-1326
Practice Address - Street 1:115 S ST JOSEPH AVE
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:MI
Practice Address - Zip Code:49120
Practice Address - Country:US
Practice Address - Phone:269-684-4070
Practice Address - Fax:269-684-4070
Is Sole Proprietor?:No
Enumeration Date:2013-11-11
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
MI68010959341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical