Healthcare Provider Details

I. General information

NPI: 1417945817
Provider Name (Legal Business Name): HARRY CHESTER HURST LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 08/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1241 N MAIN ST
HARRISONBURG VA
22802
US

IV. Provider business mailing address

1241 N MAIN ST
HARRISONBURG VA
22802-4632
US

V. Phone/Fax

Practice location:
  • Phone: 540-434-6093
  • Fax: 540-434-1766
Mailing address:
  • Phone: 540-434-6093
  • Fax: 540-434-1766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701001716
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: