Provider Demographics
NPI:1215793583
Name:MURPHY, JACQUELINE D
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:D
Last Name:MURPHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 471492
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80047-1492
Mailing Address - Country:US
Mailing Address - Phone:720-336-1472
Mailing Address - Fax:
Practice Address - Street 1:21301 E 48TH PL
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80249-7537
Practice Address - Country:US
Practice Address - Phone:720-336-1472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-26
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0020164101YM0800X
COLPC.0021779101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health