Provider Demographics
NPI:1386906469
Name:MACNAMARA-MURPHY, SINEAD M (LCSW)
Entity type:Individual
Prefix:
First Name:SINEAD
Middle Name:M
Last Name:MACNAMARA-MURPHY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 KENSICO RD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-6331
Mailing Address - Country:US
Mailing Address - Phone:845-406-8804
Mailing Address - Fax:
Practice Address - Street 1:64 GLENEIDA AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-1221
Practice Address - Country:US
Practice Address - Phone:845-406-8804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-13
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000987101YA0400X
NY26735101YA0400X
NY0804631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008031626Medicaid
CT004123840Medicaid
CT008017939Medicaid