Healthcare Provider Details

I. General information

NPI: 1235014879
Provider Name (Legal Business Name): HALEIGH KRISTIAN HURLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HALEIGH KRISTIAN MITCHELL

II. Dates (important events)

Enumeration Date: 08/11/2025
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1104 S MAIN ST STE B
LEXINGTON NC
27292-3134
US

IV. Provider business mailing address

284 EXECUTIVE PARK DR STE 100
CONCORD NC
28025-1833
US

V. Phone/Fax

Practice location:
  • Phone: 336-300-8826
  • Fax:
Mailing address:
  • Phone: 704-939-1100
  • Fax: 704-939-1173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberA21852
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: