Provider Demographics
NPI:1174058135
Name:MURPHY, BRIDGET (LCSW, CSAC)
Entity type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:LCSW, CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7040 HAWAII KAI DRIVE
Mailing Address - Street 2:# 25672
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-0672
Mailing Address - Country:US
Mailing Address - Phone:808-398-0481
Mailing Address - Fax:
Practice Address - Street 1:1110 UNIVERSITY AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1540
Practice Address - Country:US
Practice Address - Phone:808-398-0481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-27
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HICSAC-1929-17101YA0400X
HILCSW-39221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)