Healthcare Provider Details

I. General information

NPI: 1750095907
Provider Name (Legal Business Name): KEVIN L HURST MSW, LSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2023
Last Update Date: 02/23/2023
Certification Date: 02/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 OREGON PIKE
LANCASTER PA
17601-4890
US

IV. Provider business mailing address

785 5TH AVE STE 3
CHAMBERSBURG PA
17201-4232
US

V. Phone/Fax

Practice location:
  • Phone: 717-926-8843
  • Fax: 717-735-0999
Mailing address:
  • Phone: 717-263-9555
  • Fax: 717-709-6529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW132333
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: