Provider Demographics
NPI:1356234231
Name:MURDOCCO, MARY ELIZABETH NANCY (LMSW)
Entity type:Individual
Prefix:MRS
First Name:MARY ELIZABETH
Middle Name:NANCY
Last Name:MURDOCCO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:160 HOWELLS RD STE 29
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-5320
Mailing Address - Country:US
Mailing Address - Phone:631-449-3456
Mailing Address - Fax:
Practice Address - Street 1:160 HOWELLS RD STE 29
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-5320
Practice Address - Country:US
Practice Address - Phone:631-449-3456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY080143104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker