MEDICARE: DR. CHASTITY MURRAY ED.D, LMHC, NCSP

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	103TS0200X	School Psychologist	46125	NY
2	101YM0800X	Mental Health Counselor	006863	NY
3	101YM0800X	Mental Health Counselor	TPMC3597	FL

General Provider Information

NPI Number	:	1538788856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHASTITY MURRAY ED.D, LMHC, NCSP

Provider Business Mailing Address
First Line	:	376 LEXINGTON AVE UNIT 13601
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14613-7019
Country	:	US
Telephone Number	:	585-978-2701
Fax Number	:

Provider Business Practice Location Address
First Line	:	1577 W RIDGE RD STE 214
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14615-2511
Country	:	US
Telephone Number	:	585-978-2701
Fax Number	:

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

Provider Enumeration Date	:	04/16/2020
Last Update Date	:	08/04/2023

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