Healthcare Provider Details

I. General information

NPI: 1710335013
Provider Name (Legal Business Name): CHERYL A HURLEY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2016
Last Update Date: 10/14/2022
Certification Date: 10/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5548 W CORRAL PL
BEVERLY HILLS FL
34465-2729
US

IV. Provider business mailing address

13266 BYRD DR SUITE 100 393
ODESSA FL
33556-0254
US

V. Phone/Fax

Practice location:
  • Phone: 813-444-2992
  • Fax:
Mailing address:
  • Phone: 813-444-2992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: