Provider Demographics
NPI:1023882263
Name:MACMUR HEALTHCARE CONSULTING, PLLC
Entity type:Organization
Organization Name:MACMUR HEALTHCARE CONSULTING, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENITA
Authorized Official - Middle Name:
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FNP-BC, PMHNP-B
Authorized Official - Phone:757-769-0157
Mailing Address - Street 1:PO BOX 4651
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-0651
Mailing Address - Country:US
Mailing Address - Phone:757-769-0571
Mailing Address - Fax:757-432-3199
Practice Address - Street 1:550 FIRST COLONIAL ROAD SUITE 308
Practice Address - Street 2:4651
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-5664
Practice Address - Country:US
Practice Address - Phone:757-769-0571
Practice Address - Fax:757-432-3199
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MACMUR HEALTHCARE CONSULTING, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-08
Last Update Date:2024-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1437769627Medicaid
VA1568087369OtherINSURANCE
VA1437769627OtherINSURANCE
VA1568087369Medicaid