Individual provider Active NPI

Lyana Monique Murrell, ACSW

  • Clinical Social Worker
  • Oakland, CA
National Provider Identifier
1073917282
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
117646 Issued in CA
Practice address
3301 E 12TH St
Suite 259
Oakland, CA 94601-3424
Phone
(510) 269-9030
Fax
(510) 269-9031
NPI assigned
Oct 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X ASW70693 CA
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Social Worker 1041C0700X 117646 CA Primary

Addresses

Primary practice location

3301 E 12TH St
Suite 259
Oakland, CA 94601-3424

Mailing address

3301 E 12TH St
Suite 259
Oakland, CA 94601-3424
Phone (510) 269-9030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ASW70693CAMDCounselor
117646CAMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1073917282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 E 12TH ST",
            "address_2": "SUITE 259",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946013424",
            "telephone_number": "510-269-9030",
            "fax_number": "510-269-9031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 E 12TH ST",
            "address_2": "SUITE 259",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946013424",
            "telephone_number": "510-269-9030",
            "fax_number": "510-269-9031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURRELL",
        "first_name": "LYANA",
        "middle_name": "MONIQUE",
        "name_prefix": "Ms.",
        "credential": "ACSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-17",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "ASW70693",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "117646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.