Provider Demographics
NPI:1154962710
Name:MURRAY, MICHELLE MARIE (LPC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MARIE
Last Name:MURRAY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4746 S LANGLEY AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-1500
Mailing Address - Country:US
Mailing Address - Phone:773-425-4181
Mailing Address - Fax:
Practice Address - Street 1:7250 W COLLEGE DR STE 1W
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1398
Practice Address - Country:US
Practice Address - Phone:773-425-4181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-04
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.014436101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty