MEDICARE: MS. VIRGINIA L. HURLEY LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	C000663	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	800013622	OTHER	NC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	13293	OTHER	NC	BCBS NC

General Provider Information

NPI Number	:	1982682282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VIRGINIA L. HURLEY LCSW

Provider Business Mailing Address
First Line	:	104 BAYTREE DR
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27858-6107
Country	:	US
Telephone Number	:	252-258-1944
Fax Number	:	252-353-4967

Provider Business Practice Location Address
First Line	:	2317 EXECUTIVE CIR
Second Line	:	PERSONALIZED THERAPY, INC.
City	:	GREENVILLE
State	:	NC
Zip	:	27834-3762
Country	:	US
Telephone Number	:	252-353-4968
Fax Number	:	252-353-4967

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	03/08/2011

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