Individual provider Active NPI

Tara Anne Murphy, PSY.D.

  • Psychologist
  • Centralia, WA
National Provider Identifier
1871677138
Registry record updated Jul 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY60484916 Issued in WA
Practice address
1911 Cooks Hill Rd
Centralia, WA 98531
Phone
(360) 736-6778
Fax
(360) 736-6552
NPI assigned
Oct 24, 2006
Last updated
Jul 30, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Addiction (Substance Use Disorder) Psychologist 103TA0400X PSY20027 CA
Adult Development & Aging Psychologist 103TA0700X PSY20027 CA
Clinical Psychologist 103TC0700X PSY20027 CA
Counseling Psychologist 103TC1900X PSY20027 CA
Clinical Child & Adolescent Psychologist 103TC2200X PSY20027 CA
Family Psychologist 103TF0000X PSY20027 CA
Intellectual & Developmental Disabilities Psychologist 103TM1800X PSY20027 CA
Group Psychotherapy Psychologist 103TP2701X PSY20027 CA
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X PY60484916 WA Primary

Addresses

Primary practice location

1911 Cooks Hill Rd
Centralia, WA 98531

Mailing address

1911 Cooks Hill Rd
Centralia, WA 98531-9073
Phone (360) 736-6778

Other practice location 1

1907 Cooks Hill Rd
Centralia, WA 98531-9073
Phone (360) 736-6778

Other practice location 2

193 S Market Blvd
Chehalis, WA 98532-3037
Phone (360) 736-6778

Other practice location 3

18313 Paulson St SW
Rochester, WA 98579-9262
Phone (360) 736-6778

Other identifiers 1

IdentifierTypeStateIssuer
2088607MedicaidWA

Other names 1

  • Tara Anne Sopwith Iglesias Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PY60484916WAMDPsychologist
PSY20027CAMDIntellectual & Developmental Disabilities Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532908800000",
    "number": "1871677138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 COOKS HILL RD",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985319073",
            "telephone_number": "360-736-6778",
            "fax_number": "360-736-6552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 COOKS HILL RD",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "98531",
            "telephone_number": "360-736-6778",
            "fax_number": "360-736-6552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1907 Cooks Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Centralia",
            "state": "WA",
            "postal_code": "985319073",
            "country_code": "US",
            "telephone_number": "360-736-6778",
            "fax_number": "360-736-6552",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "193 S Market Blvd",
            "address_purpose": "LOCATION",
            "city": "Chehalis",
            "state": "WA",
            "postal_code": "985323037",
            "country_code": "US",
            "telephone_number": "360-736-6778",
            "fax_number": "360-736-6552",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18313 Paulson St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "WA",
            "postal_code": "985799262",
            "country_code": "US",
            "telephone_number": "360-736-6778",
            "fax_number": "360-736-6552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MURPHY",
        "first_name": "TARA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2018-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "PSY20027",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "CA",
            "license": "PSY20027",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY20027",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CA",
            "license": "PSY20027",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "PSY20027",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "CA",
            "license": "PSY20027",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "CA",
            "license": "PSY20027",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "CA",
            "license": "PSY20027",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY60484916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2088607",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "SOPWITH IGLESIAS",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Centralia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.