Healthcare Provider Details
I. General information
NPI: 1912199639
Provider Name (Legal Business Name): SARAH CATHLEEN HURD MSSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/16/2007
Last Update Date: 12/29/2023
Certification Date: 12/26/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
REYNOLDS ARMY HEALTH CLINIC 4301 WILSON ST
FT SILL OK
73503
US
IV. Provider business mailing address
4301 WILSON ST
FORT SILL OK
73503-4472
US
V. Phone/Fax
- Phone: 580-442-3084
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: