Healthcare Provider Details

I. General information

NPI: 1871858167
Provider Name (Legal Business Name): ASHLEY MURRY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2012
Last Update Date: 04/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13601 S 44TH ST APT 1125
PHOENIX AZ
85044-4882
US

IV. Provider business mailing address

13601 S 44TH ST APT 1125
PHOENIX AZ
85044-4882
US

V. Phone/Fax

Practice location:
  • Phone: 813-451-5881
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-16035
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW12738
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: