Provider Demographics
NPI:1205858057
Name:MURRAH, JEFFREY DIXON (LPC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:DIXON
Last Name:MURRAH
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:JEFF
Other - Middle Name:
Other - Last Name:MURRAH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:PO BOX 423
Mailing Address - Street 2:
Mailing Address - City:LA PORTE
Mailing Address - State:TX
Mailing Address - Zip Code:77572-0423
Mailing Address - Country:US
Mailing Address - Phone:713-344-0682
Mailing Address - Fax:
Practice Address - Street 1:1345 SPACE PARK DR
Practice Address - Street 2:SUITE D
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3468
Practice Address - Country:US
Practice Address - Phone:713-344-0682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11573101Y00000X
TX6714101YA0400X
TX003311-041926106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist