Provider Demographics
NPI:1942858501
Name:MURRELL, EVELYN S (LMSW, LCSW)
Entity Type:Individual
Prefix:MISS
First Name:EVELYN
Middle Name:S
Last Name:MURRELL
Suffix:
Gender:F
Credentials:LMSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:757 ATHERTON WAY
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-8095
Mailing Address - Country:US
Mailing Address - Phone:843-344-2175
Mailing Address - Fax:
Practice Address - Street 1:9635 SOUTHERN PINE BLVD STE 123
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-5563
Practice Address - Country:US
Practice Address - Phone:980-819-1920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-27
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0131211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty