Provider Demographics
NPI:1104184142
Name:HURD COUNSELING AND EDUCATIONAL PSYCHOLOGY
Entity Type:Organization
Organization Name:HURD COUNSELING AND EDUCATIONAL PSYCHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:DOESCHER
Authorized Official - Last Name:HURD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:608-228-0750
Mailing Address - Street 1:7580 VALLEY WOODS CT
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:WI
Mailing Address - Zip Code:53593-9569
Mailing Address - Country:US
Mailing Address - Phone:608-228-0750
Mailing Address - Fax:
Practice Address - Street 1:700 RAYOVAC DRIVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711
Practice Address - Country:US
Practice Address - Phone:608-228-0750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-27
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2890-057103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1518277466Medicaid