MEDICARE: VIRGINIA HURST LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	149.008350	IL

General Provider Information

NPI Number	:	1295156826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIRGINIA HURST LCSW

Provider Business Mailing Address
First Line	:	3916 N LINCOLN ST
Second Line	:
City	:	WESTMONT
State	:	IL
Zip	:	60559-1110
Country	:	US
Telephone Number	:	630-689-7679
Fax Number	:	630-515-1501

Provider Business Practice Location Address
First Line	:	3916 N LINCOLN ST
Second Line	:
City	:	WESTMONT
State	:	IL
Zip	:	60559-1110
Country	:	US
Telephone Number	:	630-689-7679
Fax Number	:	630-515-1501

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2013
Last Update Date	:	03/04/2016

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Directions to “ VIRGINIA HURST LCSW” Practice Location

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