Provider Demographics
NPI:1417518010
Name:HURLEY, REBECCA BROOKE (CSW)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:BROOKE
Last Name:HURLEY
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 550
Mailing Address - Street 2:
Mailing Address - City:BARBOURVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40906-0550
Mailing Address - Country:US
Mailing Address - Phone:606-546-3805
Mailing Address - Fax:
Practice Address - Street 1:1909 KY 3439
Practice Address - Street 2:
Practice Address - City:BARBOURVILLE
Practice Address - State:KY
Practice Address - Zip Code:40906-7201
Practice Address - Country:US
Practice Address - Phone:606-546-3805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY252283101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor