Provider Demographics
NPI:1184783037
Name:MURRAY, RONNI E (LCSW)
Entity type:Individual
Prefix:
First Name:RONNI
Middle Name:E
Last Name:MURRAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 LEHIGH AVE.
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07112-1811
Mailing Address - Country:US
Mailing Address - Phone:973-926-8180
Mailing Address - Fax:
Practice Address - Street 1:210 LEHIGH AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-1811
Practice Address - Country:US
Practice Address - Phone:973-926-8180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0138661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA017334Medicare ID - Type UnspecifiedMEDICARE NUMBER