Provider Demographics
NPI:1013285782
Name:BROCK-MURRAY, RAYMOND (LPC)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:
Last Name:BROCK-MURRAY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 NEWARK ST STE 25A
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-5610
Mailing Address - Country:US
Mailing Address - Phone:201-448-7234
Mailing Address - Fax:
Practice Address - Street 1:1 NEWARK ST STE 25A
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-5610
Practice Address - Country:US
Practice Address - Phone:201-448-7234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-08
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00433400101YP2500X
NY019925-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103T00000XBehavioral Health & Social Service ProvidersPsychologist