Provider Demographics
NPI:1396253076
Name:MURRAY, MELVIA MICHELLE (LCPC-S)
Entity type:Individual
Prefix:
First Name:MELVIA
Middle Name:MICHELLE
Last Name:MURRAY
Suffix:
Gender:F
Credentials:LCPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E LOMBARD ST STE 840
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-3231
Mailing Address - Country:US
Mailing Address - Phone:443-788-8077
Mailing Address - Fax:
Practice Address - Street 1:300 E LOMBARD ST STE 840
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-3231
Practice Address - Country:US
Practice Address - Phone:443-788-8077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-17
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC10222101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health