Provider Demographics
NPI:1225492010
Name:MURRAY, MARIE (MA LPC, ATR)
Entity Type:Individual
Prefix:MS
First Name:MARIE
Middle Name:
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MA LPC, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2775 MACKINTOSH LN
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0934
Mailing Address - Country:US
Mailing Address - Phone:248-933-6443
Mailing Address - Fax:
Practice Address - Street 1:1222 S WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-3222
Practice Address - Country:US
Practice Address - Phone:248-547-2260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-08
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI640102906101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health