Provider Demographics
NPI:1053404533
Name:ED MURPHY & ASSOCIATES
Entity type:Organization
Organization Name:ED MURPHY & ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:III
Authorized Official - Credentials:LCSW
Authorized Official - Phone:540-368-3098
Mailing Address - Street 1:181 KINGS HWY
Mailing Address - Street 2:SUITE 127
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22405-2685
Mailing Address - Country:US
Mailing Address - Phone:540-368-3098
Mailing Address - Fax:540-368-3153
Practice Address - Street 1:1410 DUSTY RD
Practice Address - Street 2:
Practice Address - City:BUMPASS
Practice Address - State:VA
Practice Address - Zip Code:23024-2721
Practice Address - Country:US
Practice Address - Phone:540-872-4545
Practice Address - Fax:540-872-4546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2011-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA67114001323P00000X
VA67114002323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010050014Medicaid
VA010316341Medicaid