Provider Demographics
NPI:1457639841
Name:MURRAY, BRUCE PITCAIRN (LCSW)
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:PITCAIRN
Last Name:MURRAY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:539 W SEDGWICK ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-3430
Mailing Address - Country:US
Mailing Address - Phone:215-848-0245
Mailing Address - Fax:
Practice Address - Street 1:250 S 17TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-6313
Practice Address - Country:US
Practice Address - Phone:215-545-7895
Practice Address - Fax:215-545-7870
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0138911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical