Provider Demographics
NPI:1275627861
Name:HURSH, MARGUERITE COPE (LPC)
Entity Type:Individual
Prefix:MS
First Name:MARGUERITE
Middle Name:COPE
Last Name:HURSH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15141 OLDDALE ROAD
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-1409
Mailing Address - Country:US
Mailing Address - Phone:703-631-6982
Mailing Address - Fax:703-631-6982
Practice Address - Street 1:5675 STONE RD
Practice Address - Street 2:SUITE 300
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20120-1667
Practice Address - Country:US
Practice Address - Phone:703-715-6077
Practice Address - Fax:703-631-6982
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002921101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7874579OtherAETNA BEHAVIORAL HEALTH
VAK016-0001OtherBLUECROSS BLUESHIELD
VA144126OtherANTHEM BEHAVIORAL HEALTH
VA222672OtherKAISER PERMANENTE BEHAVIO