Healthcare Provider Details

I. General information

NPI: 1619193422
Provider Name (Legal Business Name): NATOYA NICOLE MCMURRAY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 RALPH MCGILL BLVD NE STE 301
ATLANTA GA
30308-3339
US

IV. Provider business mailing address

3519 DEVON CHASE RD
ATLANTA GA
30349-3685
US

V. Phone/Fax

Practice location:
  • Phone: 404-589-9040
  • Fax: 404-589-1615
Mailing address:
  • Phone: 404-808-6713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW003787
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: