Provider Demographics
NPI:1922756592
Name:MURRAY, AVA D (LCSW, RN)
Entity Type:Individual
Prefix:MS
First Name:AVA
Middle Name:D
Last Name:MURRAY
Suffix:
Gender:F
Credentials:LCSW, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6235
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00823-6235
Mailing Address - Country:US
Mailing Address - Phone:407-619-4429
Mailing Address - Fax:
Practice Address - Street 1:5030 ANCHOR WAY STE 9
Practice Address - Street 2:
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820-4692
Practice Address - Country:US
Practice Address - Phone:430-719-7007
Practice Address - Fax:340-719-6655
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-14
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW94391041C0700X
VI2-27843-1B1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty