Provider Demographics
NPI:1194164053
Name:MURPHY, CAROLYN D (PHD)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:D
Last Name:MURPHY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:D
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SSP
Mailing Address - Street 1:520 7TH ST W UNIT 1802
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34220-7073
Mailing Address - Country:US
Mailing Address - Phone:571-310-1399
Mailing Address - Fax:
Practice Address - Street 1:210 15TH AVE W
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:FL
Practice Address - Zip Code:34221-4432
Practice Address - Country:US
Practice Address - Phone:571-310-1399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-24
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9573103T00000X, 103TC0700X
VA0810-006073103T00000X, 103TC0700X
103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool