Provider Demographics
NPI:1235458860
Name:HURST, SHEILA A (CAP)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:A
Last Name:HURST
Suffix:
Gender:F
Credentials:CAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 57TH ST # A
Mailing Address - Street 2:
Mailing Address - City:HOLMES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34217-1502
Mailing Address - Country:US
Mailing Address - Phone:941-448-3940
Mailing Address - Fax:
Practice Address - Street 1:308 57TH ST # A
Practice Address - Street 2:
Practice Address - City:HOLMES BEACH
Practice Address - State:FL
Practice Address - Zip Code:34217-1502
Practice Address - Country:US
Practice Address - Phone:941-448-3940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-21
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4489101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4489OtherCAP