Healthcare Provider Details

I. General information

NPI: 1467878876
Provider Name (Legal Business Name): KERRIE G MURPHY PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KERRIE GLASS

II. Dates (important events)

Enumeration Date: 03/10/2014
Last Update Date: 06/26/2023
Certification Date: 06/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

884 ALLBRITTON BLVD SUITE 210
MT. PLEASANT SC
29464-8908
US

IV. Provider business mailing address

106 BELLINGER STREET
DANIEL ISLAND SC
29492
US

V. Phone/Fax

Practice location:
  • Phone: 843-632-5806
  • Fax:
Mailing address:
  • Phone: 843-632-5806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1363
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3127
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: