Healthcare Provider Details

I. General information

NPI: 1114328457
Provider Name (Legal Business Name): SHARON BROOKE HURT LCPC, ACADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHARON BROOKE MARSHALL LCPC, ACADC

II. Dates (important events)

Enumeration Date: 09/05/2014
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2647 KIMBERLY RD STE 2
TWIN FALLS ID
83301-7976
US

IV. Provider business mailing address

794 EASTLAND DR
TWIN FALLS ID
83301-6856
US

V. Phone/Fax

Practice location:
  • Phone: 208-734-1281
  • Fax: 208-734-1282
Mailing address:
  • Phone: 208-734-1281
  • Fax: 208-734-1282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberACADC13036
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLCPC7530
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: