Provider Demographics
NPI:1831456862
Name:MCMURRAY, NATHAN W (MS, LPC, NCC)
Entity type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:W
Last Name:MCMURRAY
Suffix:
Gender:M
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 W MAPLE RD STE 123
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-7047
Mailing Address - Country:US
Mailing Address - Phone:248-457-5497
Mailing Address - Fax:248-457-5497
Practice Address - Street 1:2820 W MAPLE RD STE 123
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-7047
Practice Address - Country:US
Practice Address - Phone:248-457-5497
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-16
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011656101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1831456862Medicaid