Provider Demographics
NPI:1740551217
Name:MURRAY, ALISSA BRAE (LCSW)
Entity type:Individual
Prefix:
First Name:ALISSA
Middle Name:BRAE
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 1:78 FERONIA WAY
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-2102
Mailing Address - Country:US
Mailing Address - Phone:201-615-2366
Mailing Address - Fax:
Practice Address - Street 1:176 PALISADE AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-1121
Practice Address - Country:US
Practice Address - Phone:201-795-8200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-15
Last Update Date:2012-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054879001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical