Provider Demographics
NPI:1447366687
Name:MURPHY, JOHN ANDREW (LCSW,LADC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ANDREW
Last Name:MURPHY
Suffix:
Gender:M
Credentials:LCSW,LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 AUGUR ST
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06517-3317
Mailing Address - Country:US
Mailing Address - Phone:203-624-3248
Mailing Address - Fax:203-624-3248
Practice Address - Street 1:60 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-2157
Practice Address - Country:US
Practice Address - Phone:203-318-8256
Practice Address - Fax:203-624-3248
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000230101YA0400X
CT0001251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT000125OtherCT.LICENSE # LCSW
CT000230OtherCT.LIC # LADC