=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033925839
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BLANCHE W MURPHY LCPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/06/2024
-----------------------------------------------------
Last Update Date | 04/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 17637 W JULIE LN
-----------------------------------------------------
City | GURNEE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60031-4217
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 224-369-6966
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1146 S WAUKEGAN RD # 183
-----------------------------------------------------
City | WAUKEGAN
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60085-6731
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 224-369-6966
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 180.016609
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------