Healthcare Provider Details

I. General information

NPI: 1578242376
Provider Name (Legal Business Name): LYNN MURPHY LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2023
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 MERCHANTS ROW STE 212
RUTLAND VT
05701-5928
US

IV. Provider business mailing address

30 CHATTERTON PARK
PROCTOR VT
05765-1303
US

V. Phone/Fax

Practice location:
  • Phone: 802-353-6554
  • Fax:
Mailing address:
  • Phone: 802-353-6554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number089.0135425
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: