Healthcare Provider Details

I. General information

NPI: 1578650255
Provider Name (Legal Business Name): TONYA KAY MCMURRAY M.ED., LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 05/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 US ROUTE 5 S
NORWICH VT
05055-9431
US

IV. Provider business mailing address

319 US ROUTE 5 S
NORWICH VT
05055-9431
US

V. Phone/Fax

Practice location:
  • Phone: 802-649-3268
  • Fax: 802-649-3270
Mailing address:
  • Phone: 802-649-3268
  • Fax: 802-649-3270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number622
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number068.0055033
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: