Provider Demographics
NPI:1871584326
Name:MURPHY, CASEY PATRICK (ED D)
Entity type:Individual
Prefix:DR
First Name:CASEY
Middle Name:PATRICK
Last Name:MURPHY
Suffix:
Gender:M
Credentials:ED D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 N 31ST AVE
Mailing Address - Street 2:A-105
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85051-9582
Mailing Address - Country:US
Mailing Address - Phone:602-843-0000
Mailing Address - Fax:602-997-1305
Practice Address - Street 1:10000 N 31ST AVE
Practice Address - Street 2:A-105
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-9582
Practice Address - Country:US
Practice Address - Phone:602-843-0000
Practice Address - Fax:602-997-1305
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1631103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ622648Medicaid