Provider Demographics
NPI:1558934505
Name:MURRAY, CHELSEA M
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:M
Last Name:MURRAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 DISK DR
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-6638
Mailing Address - Country:US
Mailing Address - Phone:541-773-3863
Mailing Address - Fax:541-500-8171
Practice Address - Street 1:2265 ASHLAND ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1490
Practice Address - Country:US
Practice Address - Phone:541-773-3863
Practice Address - Fax:541-500-8171
Is Sole Proprietor?:No
Enumeration Date:2021-07-19
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC8729101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health