Healthcare Provider Details

I. General information

NPI: 1699450395
Provider Name (Legal Business Name): ALEC WESLEY HURST LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2023
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2515 W ALLEN DR
SPRINGFIELD MO
65810-1300
US

IV. Provider business mailing address

1331 ABERCORN ST
REPUBLIC MO
65738-5510
US

V. Phone/Fax

Practice location:
  • Phone: 417-576-8410
  • Fax:
Mailing address:
  • Phone: 808-304-8823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2025043582
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: