MEDICARE: MICHELLE MURPHY LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	59417933501	UT

General Provider Information

NPI Number	:	1720212517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE MURPHY LCSW

Provider Business Mailing Address
First Line	:	4432 ADONIS DR
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84124-3923
Country	:	US
Telephone Number	:	801-502-4580
Fax Number	:

Provider Business Practice Location Address
First Line	:	2180 E 4500 S
Second Line	:	MEDICAL VILLAGE - SUITE 245
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84117-4434
Country	:	US
Telephone Number	:	801-274-2590
Fax Number	:	801-274-2748

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2009
Last Update Date	:	05/07/2009

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Directions to “ MICHELLE MURPHY LCSW” Practice Location

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