Healthcare Provider Details

I. General information

NPI: 1326217092
Provider Name (Legal Business Name): GEORGE ADAMS HURT JR. LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2008
Last Update Date: 02/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 DOE RUN DR
KERNERSVILLE NC
27284-8000
US

IV. Provider business mailing address

640 DOE RUN DR
KERNERSVILLE NC
27284-8000
US

V. Phone/Fax

Practice location:
  • Phone: 335-508-4562
  • Fax:
Mailing address:
  • Phone: 335-508-4562
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number4069
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: