Provider Demographics
NPI:1962464107
Name:MURRAY-CARNEY, MELITA J (PHD)
Entity Type:Individual
Prefix:DR
First Name:MELITA
Middle Name:J
Last Name:MURRAY-CARNEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7730 CENTERBROOK LN
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-9229
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2701 GOODES BRIDGE RD
Practice Address - Street 2:SUITE 3
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23224-2555
Practice Address - Country:US
Practice Address - Phone:804-674-0455
Practice Address - Fax:804-271-3399
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002497103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0245365OtherANTHEM BLUE CROSS
VA0245365OtherANTHEM BLUE CROSS