Basic Information
| Provider Information | |||||||||
| NPI: | 1558725812 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MURPHY | ||||||||
| FirstName: | AMANDA | ||||||||
| MiddleName: | |||||||||
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| Credential: | LPCC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1501 MADISON RD | ||||||||
| Address2: | |||||||||
| City: | WALNUT HILLS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452061706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5133541190 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7140 OFFICE PARK DR | ||||||||
| Address2: | |||||||||
| City: | WEST CHESTER | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5137772428 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2016 | ||||||||
| LastUpdateDate: | 08/15/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | E.1800684 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Professional | 101YM0800X | C1600075 | OH | N | Behavioral Health & Social Service Providers | Counselor | Mental Health |
ID Information
| ID | Type | State | Issuer | Description | C1600075 | 01 | OH | COUNSELOR, SOCIAL WORKER, MARRIAGE AND FAMILY THERAPIST BOARD | OTHER |