Healthcare Provider Details

I. General information

NPI: 1154943389
Provider Name (Legal Business Name): CHARNELL C MURPHY MAJOR ON MENTHAL HEA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHARNELL C MURPHY CHARNELL C MURPHY

II. Dates (important events)

Enumeration Date: 05/11/2020
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 PINEY FOREST RD STE 401E
DANVILLE VA
24540-2870
US

IV. Provider business mailing address

625 PINEY FOREST RD STE 401E
DANVILLE VA
24540-2870
US

V. Phone/Fax

Practice location:
  • Phone: 434-374-1713
  • Fax:
Mailing address:
  • Phone: 434-822-3698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701010228
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number16752
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8153
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: