Healthcare Provider Details

I. General information

NPI: 1730074733
Provider Name (Legal Business Name): JULIUS HURST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2025
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3559 STANFORD PL
DAYTON OH
45406-3641
US

IV. Provider business mailing address

1415 SALEM AVE
DAYTON OH
45406-4941
US

V. Phone/Fax

Practice location:
  • Phone: 937-723-8475
  • Fax:
Mailing address:
  • Phone: 937-723-8475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: