Healthcare Provider Details

I. General information

NPI: 1730682089
Provider Name (Legal Business Name): BRIAN JAMES MURPHY LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2018
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 S NEVADA AVE
COLO SPGS CO
80903-4006
US

IV. Provider business mailing address

5147 BELLE STAR DR
COLO SPGS CO
80922-3604
US

V. Phone/Fax

Practice location:
  • Phone: 719-471-9992
  • Fax:
Mailing address:
  • Phone: 719-930-4147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number09923941
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: