Provider Demographics
NPI:1053629394
Name:MCMURRY, LAURA L (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:L
Last Name:MCMURRY
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7479
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65205-7479
Mailing Address - Country:US
Mailing Address - Phone:573-447-8388
Mailing Address - Fax:573-447-7433
Practice Address - Street 1:1900 N PROVIDENCE RD STE 305
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65202-3710
Practice Address - Country:US
Practice Address - Phone:573-447-8388
Practice Address - Fax:573-447-7433
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-21
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0062471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1053629394Medicaid