Healthcare Provider Details

I. General information

NPI: 1700773702
Provider Name (Legal Business Name): JORDAN HURST LMFT & LPC ASSOCIATE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2025
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 W LYNN ST STE 206
AUSTIN TX
78703-3903
US

IV. Provider business mailing address

1300 W LYNN ST STE 206
AUSTIN TX
78703-3903
US

V. Phone/Fax

Practice location:
  • Phone: 512-348-8771
  • Fax:
Mailing address:
  • Phone: 512-348-8771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number206014
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number99117
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: