Healthcare Provider Details

I. General information

NPI: 1467087270
Provider Name (Legal Business Name): KRISTIN HURST MS, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2020
Last Update Date: 12/13/2022
Certification Date: 12/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1302 NOBLE ST STE 3H
ANNISTON AL
36201-4678
US

IV. Provider business mailing address

1302 NOBLE ST STE 3H
ANNISTON AL
36201-4678
US

V. Phone/Fax

Practice location:
  • Phone: 256-530-2030
  • Fax:
Mailing address:
  • Phone: 256-530-2030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC04784
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: