Provider Demographics
NPI:1023862307
Name:MURRELL, TRACI MIGNON (LCPC)
Entity type:Individual
Prefix:
First Name:TRACI
Middle Name:MIGNON
Last Name:MURRELL
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12918 QUAIL PARK DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-3597
Mailing Address - Country:US
Mailing Address - Phone:832-330-5470
Mailing Address - Fax:
Practice Address - Street 1:12918 QUAIL PARK DR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-3597
Practice Address - Country:US
Practice Address - Phone:832-330-5470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral