Provider Demographics
NPI:1669793931
Name:MURRAY, SUZANNE MARIE (LCSW)
Entity type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:MARIE
Last Name:MURRAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7223 W SILVER SAND DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85743-1216
Mailing Address - Country:US
Mailing Address - Phone:520-907-0452
Mailing Address - Fax:520-744-9529
Practice Address - Street 1:7223 W SILVER SAND DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85743-1216
Practice Address - Country:US
Practice Address - Phone:520-907-0452
Practice Address - Fax:520-744-9529
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-21
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW35331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z141121OtherMEDICARE PROVIDER TRANSACTION ACCESS NUMBER (PTAN)