Provider Demographics
NPI:1093525255
Name:MURRAY, TIERRA MECHELE (LCSW)
Entity type:Individual
Prefix:
First Name:TIERRA
Middle Name:MECHELE
Last Name:MURRAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 E TC JESTER BLVD APT 516
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-2570
Mailing Address - Country:US
Mailing Address - Phone:478-357-5394
Mailing Address - Fax:
Practice Address - Street 1:6805 TENNILLE OCONEE RD
Practice Address - Street 2:
Practice Address - City:TENNILLE
Practice Address - State:GA
Practice Address - Zip Code:31089-2617
Practice Address - Country:US
Practice Address - Phone:478-357-5394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0092381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical