Provider Demographics
NPI:1609538909
Name:MURPHY, SHANNON (LCSW, LICSW)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:LCSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3017 GARFIELD AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-2924
Mailing Address - Country:US
Mailing Address - Phone:352-262-6263
Mailing Address - Fax:
Practice Address - Street 1:3017 GARFIELD AVE APT 2
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-2924
Practice Address - Country:US
Practice Address - Phone:352-262-6263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-13
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW190431041C0700X
MN343521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical