Healthcare Provider Details

I. General information

NPI: 1780109769
Provider Name (Legal Business Name): CLAY HURLEY PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2017
Last Update Date: 04/19/2023
Certification Date: 04/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1068 N CHURCH ST STE 201B
GREENVILLE SC
29601-1769
US

IV. Provider business mailing address

1068 N CHURCH ST STE 201B
GREENVILLE SC
29601-1769
US

V. Phone/Fax

Practice location:
  • Phone: 864-729-2423
  • Fax:
Mailing address:
  • Phone: 864-729-2423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS018322
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: