Healthcare Provider Details

I. General information

NPI: 1902164486
Provider Name (Legal Business Name): DANETTE C HURST MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2012
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4601 JENKIP CT
MOSELEY VA
23120-2284
US

IV. Provider business mailing address

4601 JENKIP CT
MOSELEY VA
23120-2284
US

V. Phone/Fax

Practice location:
  • Phone: 804-928-4737
  • Fax:
Mailing address:
  • Phone: 804-708-0478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701002480
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: