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General NPI Number Information
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NPI Number | 1255054078
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Entity Type | Organization
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Legal Business Name | TIMOTHY D MURPHY
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Dates
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Enumeration Date | 09/26/2022
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Last Update Date | 09/26/2022
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Provider Practice Location Address
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Address Line | 850 NW FEDERAL HWY STE 166
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City | STUART
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State | FL
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Zip | 34994-1019
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Country | US
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Telephone | 561-373-4630
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Fax |
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Provider Business Mailing Address
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Address Line | 12420 SW WEEPING WILLOW AVE
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City | PORT ST LUCIE
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State | FL
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Zip | 34987-2839
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Country | US
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Telephone | 561-373-4630
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TIMOTHY MURPHY
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Credential | LMHC
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Telephone | 561-373-4630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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