Healthcare Provider Details

I. General information

NPI: 1861252744
Provider Name (Legal Business Name): ADAM HURLBURT MS, LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2024
Last Update Date: 03/19/2024
Certification Date: 03/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8328 NW 26TH CT
PEMBROKE PINES FL
33024-3183
US

IV. Provider business mailing address

8328 NW 26TH CT
PEMBROKE PINES FL
33024-3183
US

V. Phone/Fax

Practice location:
  • Phone: 802-730-6975
  • Fax:
Mailing address:
  • Phone: 802-730-6975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT4529
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: