Provider Demographics
NPI:1104513902
Name:MURPHY, DIANNA KELLER (LPC)
Entity type:Individual
Prefix:
First Name:DIANNA
Middle Name:KELLER
Last Name:MURPHY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 FARMERS RD
Mailing Address - Street 2:
Mailing Address - City:ELLOREE
Mailing Address - State:SC
Mailing Address - Zip Code:29047-9597
Mailing Address - Country:US
Mailing Address - Phone:813-690-3537
Mailing Address - Fax:
Practice Address - Street 1:910 FARMERS RD
Practice Address - Street 2:
Practice Address - City:ELLOREE
Practice Address - State:SC
Practice Address - Zip Code:29047-9597
Practice Address - Country:US
Practice Address - Phone:803-308-3332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC101YP1600X
SC6620101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral