Healthcare Provider Details

I. General information

NPI: 1528396462
Provider Name (Legal Business Name): KATHLEEN MARIE HURLEY M.ED, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2009
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 CRESTWOOD EXECUTIVE CTR STE 435
SAINT LOUIS MO
63126-1916
US

IV. Provider business mailing address

50 CRESTWOOD EXECUTIVE CTR STE 435
SAINT LOUIS MO
63126-1916
US

V. Phone/Fax

Practice location:
  • Phone: 314-690-1667
  • Fax: 314-677-3404
Mailing address:
  • Phone: 314-690-1667
  • Fax: 314-677-3404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2010024366
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: