Provider Demographics
NPI:1518618438
Name:MURRAY, MADELINE H (LCPC)
Entity Type:Individual
Prefix:MS
First Name:MADELINE
Middle Name:H
Last Name:MURRAY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1643 N MOZART ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-0790
Mailing Address - Country:US
Mailing Address - Phone:630-297-5611
Mailing Address - Fax:
Practice Address - Street 1:715 LAKE ST STE 510
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1414
Practice Address - Country:US
Practice Address - Phone:708-573-0424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-12
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.014120101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional