Healthcare Provider Details

I. General information

NPI: 1427267178
Provider Name (Legal Business Name): STEPHANIE R HURLEY LPCC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANIE R HENDERSON LPCC-S

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 07/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3914 MIAMI RD STE 209
CINCINNATI OH
45227
US

IV. Provider business mailing address

1735 BLOOMINGDALE AVE
CINCINNATI OH
45230-1760
US

V. Phone/Fax

Practice location:
  • Phone: 513-440-3134
  • Fax:
Mailing address:
  • Phone: 513-477-4523
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE0008009
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: