Provider Demographics
NPI:1538721410
Name:MURAKAMI, MAURISSA L (LPC)
Entity type:Individual
Prefix:
First Name:MAURISSA
Middle Name:L
Last Name:MURAKAMI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MAURISSA
Other - Middle Name:
Other - Last Name:STORCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1010 JORIE BLVD STE 112
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-4446
Mailing Address - Country:US
Mailing Address - Phone:224-325-4513
Mailing Address - Fax:
Practice Address - Street 1:1010 JORIE BLVD STE 112
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-4446
Practice Address - Country:US
Practice Address - Phone:224-325-4513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.010736101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional