Basic Information
| Provider Information | |||||||||
| NPI: | 1134558141 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MURPHY | ||||||||
| FirstName: | PATRICK | ||||||||
| MiddleName: | JOHN | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6270 W MAIN ST | ||||||||
| Address2: | |||||||||
| City: | EAU CLAIRE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 491119480 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8558696900 | ||||||||
| FaxNumber: | 2699271326 | ||||||||
| Practice Location | |||||||||
| Address1: | 115 S ST JOSEPH AVE | ||||||||
| Address2: | |||||||||
| City: | NILES | ||||||||
| State: | MI | ||||||||
| PostalCode: | 49120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2696844070 | ||||||||
| FaxNumber: | 2696844070 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/11/2013 | ||||||||
| LastUpdateDate: | 12/13/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | 6801095934 | MI | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.