Basic Information
Provider Information
NPI: 1245570720
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MURRAY
FirstName: AMBER
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LMSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1430 COLLIER ST
Address2:  
City: AUSTIN
State: TX
PostalCode: 787042911
CountryCode: US
TelephoneNumber: 5124724357
FaxNumber: 5127031394
Practice Location
Address1: 1631 E 2ND ST STE D
Address2:  
City: AUSTIN
State: TX
PostalCode: 787024491
CountryCode: US
TelephoneNumber: 5128043600
FaxNumber: 5124761469
Other Information
ProviderEnumerationDate: 02/21/2013
LastUpdateDate: 02/21/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000X56052TXY Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


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