Provider Demographics
NPI:1447084462
Name:MURRAY, LISA B (LCPCC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:B
Last Name:MURRAY
Suffix:
Gender:F
Credentials:LCPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 PORTLAND ST
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-6763
Mailing Address - Country:US
Mailing Address - Phone:207-232-6861
Mailing Address - Fax:
Practice Address - Street 1:162 MAIN ST
Practice Address - Street 2:
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096-6712
Practice Address - Country:US
Practice Address - Phone:207-232-6861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL6580101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health