Provider Demographics
NPI:1588894141
Name:MURPHY, STACEY L (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:L
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:STACEY
Other - Middle Name:L
Other - Last Name:MARCOSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:1230 BARBOUR AVE
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT BORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-4019
Mailing Address - Country:US
Mailing Address - Phone:732-714-6373
Mailing Address - Fax:
Practice Address - Street 1:425 JACK MARTIN BLVD
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-7732
Practice Address - Country:US
Practice Address - Phone:732-836-4140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-16
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SCO53123001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
STP23690Medicare PIN