Provider Demographics
NPI:1831839505
Name:MURRY, AQUA ARLENE (LCSWA)
Entity type:Individual
Prefix:
First Name:AQUA
Middle Name:ARLENE
Last Name:MURRY
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:AQUA
Other - Middle Name:ARLENE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:709 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-3265
Mailing Address - Country:US
Mailing Address - Phone:336-378-0109
Mailing Address - Fax:336-378-0180
Practice Address - Street 1:709 E MARKET ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-3265
Practice Address - Country:US
Practice Address - Phone:336-378-0109
Practice Address - Fax:336-378-0180
Is Sole Proprietor?:No
Enumeration Date:2022-03-30
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0169261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical