Basic Information
Provider Information
NPI: 1497195044
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MURPHY
FirstName: CLAIRE
MiddleName: B
NamePrefix: MS.
NameSuffix:  
Credential: LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1008 FETTERMAN DR
Address2:  
City: LARAMIE
State: WY
PostalCode: 820704639
CountryCode: US
TelephoneNumber: 3077214077
FaxNumber:  
Practice Location
Address1: 504 S 4TH ST
Address2:  
City: LARAMIE
State: WY
PostalCode: 820703704
CountryCode: US
TelephoneNumber: 3077551000
FaxNumber: 3077429717
Other Information
ProviderEnumerationDate: 06/27/2013
LastUpdateDate: 06/27/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500XLPC-072WYY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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