Healthcare Provider Details

I. General information

NPI: 1225479421
Provider Name (Legal Business Name): TIFFANY ANN MURRAY LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2013
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 CLAREMONT ST
DEARBORN MI
48124-1305
US

IV. Provider business mailing address

21539 HOMER ST
DEARBORN MI
48124-2910
US

V. Phone/Fax

Practice location:
  • Phone: 313-654-1915
  • Fax:
Mailing address:
  • Phone: 734-716-8433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801094461
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801094461
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: