Provider Demographics
NPI:1679244214
Name:MURRAY, MIRRIAH (LMFT)
Entity Type:Individual
Prefix:
First Name:MIRRIAH
Middle Name:
Last Name:MURRAY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 WOODBURY RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06793-1521
Mailing Address - Country:US
Mailing Address - Phone:860-248-5755
Mailing Address - Fax:
Practice Address - Street 1:21 ARCH BRIDGE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:CT
Practice Address - Zip Code:06751-1612
Practice Address - Country:US
Practice Address - Phone:203-266-8047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2657106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist