Healthcare Provider Details

I. General information

NPI: 1700172103
Provider Name (Legal Business Name): JULIE MARIE HURLBERT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2011
Last Update Date: 05/10/2024
Certification Date: 05/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4090 BRIARGATE PKWY
COLORADO SPRINGS CO
80920-7815
US

IV. Provider business mailing address

4090 BRIARGATE PKWY
COLORADO SPRINGS CO
80920-7815
US

V. Phone/Fax

Practice location:
  • Phone: 850-218-2354
  • Fax:
Mailing address:
  • Phone: 850-218-2354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW10137
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09926104
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: