Provider Demographics
NPI:1689699092
Name:MURRAY, TRACY L (MSW, LCSW, CTS)
Entity Type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:L
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MSW, LCSW, CTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11607 W WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-2134
Mailing Address - Country:US
Mailing Address - Phone:414-758-0234
Mailing Address - Fax:
Practice Address - Street 1:CLEMENT J ZABLOCKI VA MEDICAL CTR
Practice Address - Street 2:5000 WEST NATIONAL AVENUE, DOMICILIARY 123
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53295-0001
Practice Address - Country:US
Practice Address - Phone:414-384-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7340-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical