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General NPI Number Information
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NPI Number | 1184260010
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Entity Type | Organization
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Legal Business Name | JAMES R HURST PHD LLC
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Dates
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Enumeration Date | 11/26/2019
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Last Update Date | 02/27/2020
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Provider Practice Location Address
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Address Line | 6910 N MAIN ST UNIT 12
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City | GRANGER
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State | IN
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Zip | 46530-9681
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Country | US
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Telephone | 574-250-2282
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 251
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City | GRANGER
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State | IN
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Zip | 46530-0251
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES R. HURST
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Credential | PH.D, HSPP
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Telephone | 574-344-4159
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TE1100X
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Taxonomy Name | Exercise & Sports Psychologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103TH0004X
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Taxonomy Name | Health Psychologist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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