Provider Demographics
NPI:1265714083
Name:MURPHY, LYNETTE ALICE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:LYNETTE
Middle Name:ALICE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 BEAVER DAM RD
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:NY
Mailing Address - Zip Code:11719-9707
Mailing Address - Country:US
Mailing Address - Phone:631-730-1614
Mailing Address - Fax:631-286-5336
Practice Address - Street 1:205 BEAVER DAM RD
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:NY
Practice Address - Zip Code:11719-9707
Practice Address - Country:US
Practice Address - Phone:631-730-1614
Practice Address - Fax:631-286-5336
Is Sole Proprietor?:No
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052472-11041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool