Provider Demographics
NPI:1164005369
Name:MURRAY, KELLY (MED, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MED, BCBA, LBA
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:
Other - Last Name:HERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, BCBA, LBA
Mailing Address - Street 1:216 CHARTRES ST APT 4E
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-2288
Mailing Address - Country:US
Mailing Address - Phone:757-879-0087
Mailing Address - Fax:
Practice Address - Street 1:216 CHARTRES ST APT 4E
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-2288
Practice Address - Country:US
Practice Address - Phone:757-879-0087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-04
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1-21-57184103K00000X
LA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst