Provider Demographics
NPI:1699786863
Name:MURPHY, JEANANNE (LCPC)
Entity type:Individual
Prefix:
First Name:JEANANNE
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 E 7TH ST
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:ANACONDA
Mailing Address - State:MT
Mailing Address - Zip Code:59711-2900
Mailing Address - Country:US
Mailing Address - Phone:406-563-9463
Mailing Address - Fax:
Practice Address - Street 1:118 E 7TH ST
Practice Address - Street 2:SUITE 1C
Practice Address - City:ANACONDA
Practice Address - State:MT
Practice Address - Zip Code:59711-2900
Practice Address - Country:US
Practice Address - Phone:406-563-9463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT961-LCPC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT744783OtherBLUE CROSS/BLUE SHIELD
MT256819Medicaid