Healthcare Provider Details

I. General information

NPI: 1225978554
Provider Name (Legal Business Name): STEPHANIE HURT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10909 254TH RD
HOLTON KS
66436-8769
US

IV. Provider business mailing address

10909 254TH RD
HOLTON KS
66436-8769
US

V. Phone/Fax

Practice location:
  • Phone: 785-851-7562
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number05183
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: