Provider Demographics
NPI:1952041121
Name:MURCKO, ARIELL
Entity Type:Individual
Prefix:
First Name:ARIELL
Middle Name:
Last Name:MURCKO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9105 LAUREL RIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-0330
Mailing Address - Country:US
Mailing Address - Phone:704-609-6785
Mailing Address - Fax:
Practice Address - Street 1:9105 LAUREL RIDGE TRL
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-0330
Practice Address - Country:US
Practice Address - Phone:704-609-6785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA17406101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health