Basic Information
Provider Information
NPI: 1023120607
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MURPHY
FirstName: DENNIS
MiddleName: LEE
NamePrefix:  
NameSuffix:  
Credential: LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2600 E HILLS DR
Address2:  
City: MOORE
State: OK
PostalCode: 731609540
CountryCode: US
TelephoneNumber: 4057945820
FaxNumber: 4052249532
Practice Location
Address1: 804 W CHOCTAW AVE
Address2:  
City: CHICKASHA
State: OK
PostalCode: 730182310
CountryCode: US
TelephoneNumber: 4052220622
FaxNumber: 4052249532
Other Information
ProviderEnumerationDate: 08/31/2006
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X2097OKX Behavioral Health & Social Service ProvidersCounselorMental Health
101YP2500X2097OKX Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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