Provider Demographics
NPI:1225428121
Name:FURST, EDWARD GUY (LPC, LMFT)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:GUY
Last Name:FURST
Suffix:
Gender:M
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16688 BARAGA PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:BARAGA
Mailing Address - State:MI
Mailing Address - Zip Code:49908-9158
Mailing Address - Country:US
Mailing Address - Phone:903-870-0963
Mailing Address - Fax:906-523-9602
Practice Address - Street 1:540 DEPOT ST
Practice Address - Street 2:
Practice Address - City:HANCOCK
Practice Address - State:MI
Practice Address - Zip Code:49930-2031
Practice Address - Country:US
Practice Address - Phone:903-870-0963
Practice Address - Fax:906-523-9602
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11030101YP2500X
TX3623106H00000X
MI6401014122106H00000X
MI4101006613101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist