Provider Demographics
NPI:1841634656
Name:MURRY, YVETTE RENEE (MSW, LSW)
Entity type:Individual
Prefix:MS
First Name:YVETTE
Middle Name:RENEE
Last Name:MURRY
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 KILMER RD
Mailing Address - Street 2:SUITE 10714
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08906-7200
Mailing Address - Country:US
Mailing Address - Phone:732-397-2192
Mailing Address - Fax:
Practice Address - Street 1:15 W PROSPECT ST
Practice Address - Street 2:SUITE 2
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-2161
Practice Address - Country:US
Practice Address - Phone:732-397-2192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-23
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05431500104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker