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General NPI Number Information
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NPI Number | 1861673360
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Entity Type | Individual
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Provider Name | ANTHONY MURDOCK LEA LPC, LMFT, LSATP
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Gender | Male
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Dates
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Enumeration Date | 11/26/2007
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Last Update Date | 11/26/2007
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Provider Practice Location Address
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Address Line | 306 TURNER RD SUITE A
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City | RICHMOND
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State | VA
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Zip | 23225-6432
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Country | US
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Telephone | 804-864-2660
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Fax | 804-864-2661
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Provider Business Mailing Address
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Address Line | 9947 HULL STREET RD PMB 151
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City | RICHMOND
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State | VA
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Zip | 23236-1412
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Country | US
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Telephone | 804-864-2660
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Fax | 804-864-2660
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0718000042
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0701002283
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 0717000407
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License Number State | VA
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