Provider Demographics
NPI:1952536971
Name:MURRY HENRY, NIKKI E (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:NIKKI
Middle Name:E
Last Name:MURRY HENRY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:NIKKI
Other - Middle Name:
Other - Last Name:MURRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:102 HERITAGE WAY NE STE 302
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-4544
Mailing Address - Country:US
Mailing Address - Phone:571-258-3026
Mailing Address - Fax:
Practice Address - Street 1:102 HERITAGE WAY NE STE 302
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-4544
Practice Address - Country:US
Practice Address - Phone:571-258-3026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-19
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5427-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical