Provider Demographics
NPI:1386658995
Name:MURRAY, DEBORAH J (LICSW-MA; LCSW-R-NY)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:J
Last Name:MURRAY
Suffix:
Gender:F
Credentials:LICSW-MA; LCSW-R-NY
Other - Prefix:MS
Other - First Name:DEBORAH
Other - Middle Name:J
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW-MA; LCSW-R-NY
Mailing Address - Street 1:71 HACKS POINT RD
Mailing Address - Street 2:
Mailing Address - City:EARLEVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21919-1207
Mailing Address - Country:US
Mailing Address - Phone:978-337-3458
Mailing Address - Fax:
Practice Address - Street 1:10 WINNATUXETT BEACH RD
Practice Address - Street 2:
Practice Address - City:MATTAPOISETT
Practice Address - State:MA
Practice Address - Zip Code:02739-2127
Practice Address - Country:US
Practice Address - Phone:978-337-3458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2010-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1111131041C0700X
NY0752341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYMU P22865OtherLCSW-R
MAMU P22865Medicare ID - Type UnspecifiedLICSW