Healthcare Provider Details

I. General information

NPI: 1689790289
Provider Name (Legal Business Name): VERONICA DENISE HURD LPC-MHSP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 05/30/2024
Certification Date: 02/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

748 OVERBRIDGE LN STE 2
CHATTANOOGA TN
37405-3320
US

IV. Provider business mailing address

748 OVERBRIDGE LN STE W
CHATTANOOGA TN
37405-3320
US

V. Phone/Fax

Practice location:
  • Phone: 423-309-0723
  • Fax: 423-877-7039
Mailing address:
  • Phone: 423-309-0723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6697
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6697
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: