Healthcare Provider Details

I. General information

NPI: 1720406069
Provider Name (Legal Business Name): MEGHAN MARY HURLEY LMHC, EDM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2014
Last Update Date: 04/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

816 8TH AVENUE SLOPE WELLNESS
BROOKLYN NY
11215
US

IV. Provider business mailing address

362 EASTERN PKWY 4B
BROOKLYN NY
11225
US

V. Phone/Fax

Practice location:
  • Phone: 347-460-2277
  • Fax:
Mailing address:
  • Phone: 347-460-2277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number004872
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: