Provider Demographics
NPI:1457408692
Name:MURRAY, DARELL LASHAWN (AMFT, APCC)
Entity Type:Individual
Prefix:MR
First Name:DARELL
Middle Name:LASHAWN
Last Name:MURRAY
Suffix:
Gender:M
Credentials:AMFT, APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5337 E WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-5248
Mailing Address - Country:US
Mailing Address - Phone:559-259-3655
Mailing Address - Fax:
Practice Address - Street 1:1209 S HUGHES
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93706-2321
Practice Address - Country:US
Practice Address - Phone:559-347-7627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16256101YM0800X
CA4982101YM0800X
106H00000X
CA105789106H00000X
CA146103106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1457408692Medicaid