Provider Demographics
NPI:1164907473
Name:HURLEY, FAITH DANETTE (MS, TLPC)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:DANETTE
Last Name:HURLEY
Suffix:
Gender:F
Credentials:MS, TLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 CINEMA DR APT 2211
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-6365
Mailing Address - Country:US
Mailing Address - Phone:615-579-0789
Mailing Address - Fax:
Practice Address - Street 1:563 S WATER AVE STE E
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-6312
Practice Address - Country:US
Practice Address - Phone:615-527-3060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-02
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTLPC4123101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty