Healthcare Provider Details

I. General information

NPI: 1538082680
Provider Name (Legal Business Name): ROBERT TRAVIS HURD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 LAUREL CREEK RD SE STE 11A
CALHOUN GA
30701-7011
US

IV. Provider business mailing address

105 LAUREL CREEK RD SE STE 11A
CALHOUN GA
30701-7011
US

V. Phone/Fax

Practice location:
  • Phone: 678-986-5060
  • Fax:
Mailing address:
  • Phone: 678-986-5060
  • 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: MR. ROBERT TRAVIS HURD
Title or Position: OWNER / THERAPIST
Credential: LCSW
Phone: 678-986-5060