Provider Demographics
NPI:1619209020
Name:MURRAY, KENNETH C (PHD, LPCC-S)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:C
Last Name:MURRAY
Suffix:
Gender:M
Credentials:PHD, LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 BENEDICT AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:OH
Mailing Address - Zip Code:44857-2374
Mailing Address - Country:US
Mailing Address - Phone:419-668-1341
Mailing Address - Fax:419-668-0285
Practice Address - Street 1:282 BENEDICT AVE STE B
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:OH
Practice Address - Zip Code:44857-2712
Practice Address - Country:US
Practice Address - Phone:419-668-0311
Practice Address - Fax:740-288-4654
Is Sole Proprietor?:No
Enumeration Date:2010-02-10
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE. 0002046 SUPV101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)