Healthcare Provider Details

I. General information

NPI: 1023153004
Provider Name (Legal Business Name): CHRISTINE STUTZ HURST CMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 10/20/2022
Certification Date: 10/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

541 N SAGE HEN DR
WASHINGTON UT
84780
US

IV. Provider business mailing address

541 N SAGE HEN DR
WASHINGTON UT
84780-3156
US

V. Phone/Fax

Practice location:
  • Phone: 435-879-1858
  • Fax: 801-820-8700
Mailing address:
  • Phone: 435-879-1858
  • Fax: 801-820-8700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-1765
License Number StateWY
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6473343-6004
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: