MEDICARE: MRS. ALEXIS G MURRAY-GOLAY LCPC

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	101YP2500X	Professional Counselor	180005679	IL

General Provider Information

NPI Number	:	1801804190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALEXIS G MURRAY-GOLAY LCPC

Provider Business Mailing Address
First Line	:	1244 W ROSEDALE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60660-3453
Country	:	US
Telephone Number	:	312-933-6760
Fax Number	:

Provider Business Practice Location Address
First Line	:	36 MAIN ST
Second Line	:	PARK RIDGE PSYCHOLOGICAL SERVICES
City	:	PARK RIDGE
State	:	IL
Zip	:	60068-4059
Country	:	US
Telephone Number	:	847-692-6692
Fax Number	:

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

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	07/08/2007

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