Healthcare Provider Details

I. General information

NPI: 1134206931
Provider Name (Legal Business Name): DONNA L MURRAY LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DONNA L ELEO

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 03/02/2022
Certification Date: 02/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

197 BRIARWOOD DR
SHADY SPRING WV
25918-8436
US

IV. Provider business mailing address

197 BRIARWOOD DR
SHADY SPRING WV
25918-8436
US

V. Phone/Fax

Practice location:
  • Phone: 304-573-5141
  • Fax:
Mailing address:
  • Phone: 304-573-5141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLPC2305
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC2305
License Number StateWV
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number16255
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE0004003S
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: