Provider Demographics
NPI:1194924258
Name:MURRAY, NANCY (MA, LCDP)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MA, LCDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-2778
Mailing Address - Country:US
Mailing Address - Phone:508-821-7777
Mailing Address - Fax:508-822-2601
Practice Address - Street 1:70 MAIN ST
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-2778
Practice Address - Country:US
Practice Address - Phone:508-821-7777
Practice Address - Fax:508-822-2601
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI00130101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1309161Medicaid