Provider Demographics
NPI:1417241860
Name:MURRAY, NIA (MSW)
Entity Type:Individual
Prefix:
First Name:NIA
Middle Name:
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1807 ASHURST RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19151-2006
Mailing Address - Country:US
Mailing Address - Phone:215-681-8474
Mailing Address - Fax:
Practice Address - Street 1:523 PLYMOUTH RD.
Practice Address - Street 2:SUITE215
Practice Address - City:PLYMOUTHMEETING
Practice Address - State:PA
Practice Address - Zip Code:19462
Practice Address - Country:US
Practice Address - Phone:610-825-9400
Practice Address - Fax:610-825-7130
Is Sole Proprietor?:No
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005873101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional