Provider Demographics
NPI:1467827469
Name:HURT, JANICE LEE (LPC-S)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:LEE
Last Name:HURT
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11516 OWLING WAY
Mailing Address - Street 2:
Mailing Address - City:MANOR
Mailing Address - State:TX
Mailing Address - Zip Code:78653-3697
Mailing Address - Country:US
Mailing Address - Phone:512-658-8298
Mailing Address - Fax:
Practice Address - Street 1:1315 SAM BASS CIR
Practice Address - Street 2:SUITE A
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-2932
Practice Address - Country:US
Practice Address - Phone:512-658-8298
Practice Address - Fax:512-310-7188
Is Sole Proprietor?:No
Enumeration Date:2015-12-02
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60157101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional