Provider Demographics
NPI:1619953544
Name:MURRAY, DONNA M (PHD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:M
Last Name:MURRAY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67828 BROKAW RD
Mailing Address - Street 2:
Mailing Address - City:ST CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950
Mailing Address - Country:US
Mailing Address - Phone:740-695-6101
Mailing Address - Fax:
Practice Address - Street 1:67828 BROKAW RD
Practice Address - Street 2:
Practice Address - City:ST CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950
Practice Address - Country:US
Practice Address - Phone:740-695-6101
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3619103T00000X
WV428103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0616140Medicaid
1425029OtherTHE UMWA H & R FUNDS
690476OtherPENNSYLVANIA BLUE SHIELD
113384OtherMENTAL HEALTH NETWORK
6021977373OtherUNITED BEHAVIORAL HEALTH
WV0163115000Medicaid
Y926780OtherHEALTH PLAN OF UPPER OHIO
113384OtherMENTAL HEALTH NETWORK
Y926780OtherHEALTH PLAN OF UPPER OHIO