Provider Demographics
NPI:1306967617
Name:MURRAY, ROSANNA (LCSW)
Entity type:Individual
Prefix:MS
First Name:ROSANNA
Middle Name:
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 1:305 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2312
Mailing Address - Country:US
Mailing Address - Phone:973-509-9745
Mailing Address - Fax:973-509-9745
Practice Address - Street 1:611 BROADWAY
Practice Address - Street 2:SUITE 529
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-2608
Practice Address - Country:US
Practice Address - Phone:212-505-7386
Practice Address - Fax:212-505-7386
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR018359-11041C0700X
NJ1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical