Healthcare Provider Details

I. General information

NPI: 1063915262
Provider Name (Legal Business Name): ALISHA DANIELLE MURPHY AADC, ALC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2018
Last Update Date: 12/16/2020
Certification Date: 12/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 LEIGHTON AVE STE B
ANNISTON AL
36207-3805
US

IV. Provider business mailing address

1106 6TH AVE NE
JACKSONVILLE AL
36265-1108
US

V. Phone/Fax

Practice location:
  • Phone: 252-453-7731
  • Fax: 256-937-7063
Mailing address:
  • Phone: 256-453-7731
  • Fax: 256-937-7063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberC3411A
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number167
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: