MEDICARE: SHANNON MURPHY LCSW, LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW19043	FL
2	1041C0700X	Clinical Social Worker	34352	MN

General Provider Information

NPI Number	:	1609538909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON MURPHY LCSW, LICSW

Provider Business Mailing Address
First Line	:	3017 GARFIELD AVE APT 2
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55408-2924
Country	:	US
Telephone Number	:	352-262-6263
Fax Number	:

Provider Business Practice Location Address
First Line	:	3017 GARFIELD AVE APT 2
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55408-2924
Country	:	US
Telephone Number	:	352-262-6263
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2021
Last Update Date	:	09/03/2025

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