Provider Demographics
NPI:1417121914
Name:HURST, CHRISTINE (LCPC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:HURST
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 1ST AVE W
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-4836
Mailing Address - Country:US
Mailing Address - Phone:406-219-8689
Mailing Address - Fax:406-303-4039
Practice Address - Street 1:428 1ST AVE W
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-4836
Practice Address - Country:US
Practice Address - Phone:406-219-8689
Practice Address - Fax:406-303-4039
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3143101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
11965201OtherCAQH
MT7134373Medicaid