Healthcare Provider Details

I. General information

NPI: 1356879472
Provider Name (Legal Business Name): CYNTHIA WILLIAMS-HURT MA LLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2017
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29200 NORTHWESTERN HWY
SOUTHFIELD MI
48034-1013
US

IV. Provider business mailing address

19973 ORLEANS ST
DETROIT MI
48203-1353
US

V. Phone/Fax

Practice location:
  • Phone: 248-276-8000
  • Fax:
Mailing address:
  • Phone: 248-632-6862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number6451016414
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: