Provider Demographics
NPI:1811085905
Name:MURPHY, JEANNETTE STEPHENSON (MA LCSW)
Entity type:Individual
Prefix:MS
First Name:JEANNETTE
Middle Name:STEPHENSON
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MA LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46901-3439
Mailing Address - Country:US
Mailing Address - Phone:765-452-1119
Mailing Address - Fax:
Practice Address - Street 1:1428 S MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-1693
Practice Address - Country:US
Practice Address - Phone:765-452-1121
Practice Address - Fax:765-452-7774
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34002501A1041C0700X
IN35000417A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical