Provider Demographics
NPI:1013135193
Name:MURRELL, BERNARD (LMSW)
Entity Type:Individual
Prefix:MR
First Name:BERNARD
Middle Name:
Last Name:MURRELL
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 W GRAND ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10552-2134
Mailing Address - Country:US
Mailing Address - Phone:914-668-9124
Mailing Address - Fax:914-668-0940
Practice Address - Street 1:9 W PROSPECT AVE
Practice Address - Street 2:SUITE # 309
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-2018
Practice Address - Country:US
Practice Address - Phone:914-668-9124
Practice Address - Fax:914-668-0940
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056098-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical