Provider Demographics
NPI:1083760045
Name:MURCHISON, CAROL B (LCSW)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:B
Last Name:MURCHISON
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 1:378 CARRIAGE HOUSE DR STE B
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-2254
Mailing Address - Country:US
Mailing Address - Phone:731-664-6222
Mailing Address - Fax:731-664-4111
Practice Address - Street 1:378 CARRIAGE HOUSE DR STE B
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-2254
Practice Address - Country:US
Practice Address - Phone:731-664-6222
Practice Address - Fax:731-664-4111
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0153101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health