Provider Demographics
NPI:1972382125
Name:MURRAY, DANIEL HAMPTON (LAC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:HAMPTON
Last Name:MURRAY
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 ELM AVE
Mailing Address - Street 2:
Mailing Address - City:CHESILHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:08089-1150
Mailing Address - Country:US
Mailing Address - Phone:607-239-7988
Mailing Address - Fax:
Practice Address - Street 1:42 DELSEA DR S
Practice Address - Street 2:
Practice Address - City:GLASSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08028-2621
Practice Address - Country:US
Practice Address - Phone:844-422-3632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00662900101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health