Provider Demographics
NPI:1447373105
Name:MURPHY, KATHLEEN ANN (LICSW)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:ANN
Last Name:MURPHY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:
Other - Last Name:SHAULIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:9 CAMELLIA VILLAGE DR APT A3
Mailing Address - Street 2:
Mailing Address - City:BRANTLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36009-2448
Mailing Address - Country:US
Mailing Address - Phone:334-342-8977
Mailing Address - Fax:
Practice Address - Street 1:107 CALDWELL ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:AL
Practice Address - Zip Code:36037-2507
Practice Address - Country:US
Practice Address - Phone:334-382-8584
Practice Address - Fax:334-383-9485
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2044C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical