Healthcare Provider Details

I. General information

NPI: 1396314548
Provider Name (Legal Business Name): DOROTHY OPAL MURRY LMCH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DOROTHY LUCAS LMCH

II. Dates (important events)

Enumeration Date: 06/22/2021
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 W LAUREL ST
SEYMOUR IN
47274-2840
US

IV. Provider business mailing address

714 W LAUREL ST
SEYMOUR IN
47274-2840
US

V. Phone/Fax

Practice location:
  • Phone: 812-361-0535
  • Fax:
Mailing address:
  • Phone: 812-361-0535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39005870A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: