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General NPI Number Information
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NPI Number | 1396413670
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Entity Type | Organization
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Legal Business Name | MARY BETH MURRAY, LLC
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Dates
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Enumeration Date | 09/01/2021
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Last Update Date | 09/01/2021
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Provider Practice Location Address
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Address Line | 2025 E MAIN ST STE 214
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City | RICHMOND
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State | VA
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Zip | 23223-7073
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Country | US
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Telephone | 804-361-7804
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Fax |
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Provider Business Mailing Address
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Address Line | 602 W 19TH ST
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City | RICHMOND
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State | VA
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Zip | 23225-3605
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Country | US
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Telephone | 434-409-5900
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICIAN
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Name | MARY ELIZABETH MURRAY
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Credential | LCSW, RPT-S
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Telephone | 434-409-5900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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