MEDICARE: DONNA L MURRAY LPCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	LPC2305	WV
2	101YP2500X	Professional Counselor	LPC2305	WV
3	101YM0800X	Mental Health Counselor	16255	NC
4	101YP2500X	Professional Counselor	E0004003S	OH

General Provider Information

NPI Number	:	1134206931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA L MURRAY LPCC

Provider Business Mailing Address
First Line	:	197 BRIARWOOD DR
Second Line	:
City	:	SHADY SPRING
State	:	WV
Zip	:	25918-8436
Country	:	US
Telephone Number	:	304-573-5141
Fax Number	:

Provider Business Practice Location Address
First Line	:	197 BRIARWOOD DR
Second Line	:
City	:	SHADY SPRING
State	:	WV
Zip	:	25918-8436
Country	:	US
Telephone Number	:	304-573-5141
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	03/02/2022

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