Healthcare Provider Details

I. General information

NPI: 1750831269
Provider Name (Legal Business Name): ALICIA HURST LPC, ATR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2016
Last Update Date: 04/21/2020
Certification Date: 04/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 VERMONT AVE NW STE 520
WASHINGTON DC
20005-6342
US

IV. Provider business mailing address

1100 VERMONT AVE NW STE 520
WASHINGTON DC
20005-6342
US

V. Phone/Fax

Practice location:
  • Phone: 202-417-8812
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPRC14699
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: