Provider Demographics
NPI:1386852333
Name:MURRAY, MICHELLE (MSW, LCSW, SUD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MSW, LCSW, SUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 ENGEL ST STE 201
Mailing Address - Street 2:
Mailing Address - City:MONONA
Mailing Address - State:WI
Mailing Address - Zip Code:53713-4822
Mailing Address - Country:US
Mailing Address - Phone:608-455-6070
Mailing Address - Fax:608-455-0883
Practice Address - Street 1:2000 ENGEL ST STE 201
Practice Address - Street 2:
Practice Address - City:MONONA
Practice Address - State:WI
Practice Address - Zip Code:53713-4822
Practice Address - Country:US
Practice Address - Phone:608-455-6070
Practice Address - Fax:608-455-0883
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16810-130101YA0400X
WI7814-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1386852333Medicare PIN