Healthcare Provider Details

I. General information

NPI: 1093552127
Provider Name (Legal Business Name): LISA CORINNA MURPHY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2024
Last Update Date: 07/15/2024
Certification Date: 07/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13705 NC HIGHWAY 98 WEST
SPRING HOPE NC
27882-9287
US

IV. Provider business mailing address

13705 NC HIGHWAY 98 WEST
SPRING HOPE NC
27882-9287
US

V. Phone/Fax

Practice location:
  • Phone: 252-885-3609
  • Fax:
Mailing address:
  • Phone: 252-885-3609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberMHL-064-164
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: