Healthcare Provider Details

I. General information

NPI: 1669612842
Provider Name (Legal Business Name): DAWN MARIE MURPHY DBH, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2009
Last Update Date: 06/08/2022
Certification Date: 06/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 N PLAZA DR
APACHE JUNCTION AZ
85120-5502
US

IV. Provider business mailing address

625 N PLAZA DR
APACHE JUNCTION AZ
85120-5502
US

V. Phone/Fax

Practice location:
  • Phone: 928-373-6770
  • Fax:
Mailing address:
  • Phone: 928-373-6770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801086724
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW18864
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW130413
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: