Healthcare Provider Details

I. General information

NPI: 1972820116
Provider Name (Legal Business Name): KAMA HURLEY LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAMA HINER LCPC

II. Dates (important events)

Enumeration Date: 04/28/2010
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1043 E PARK BLVD STE 101
BOISE ID
83712-7711
US

IV. Provider business mailing address

1043 E PARK BLVD STE 101
BOISE ID
83712-7711
US

V. Phone/Fax

Practice location:
  • Phone: 208-565-2623
  • Fax: 208-502-2581
Mailing address:
  • Phone: 208-565-2623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number4480
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLCPC-5254
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: