Provider Demographics
NPI:1477278927
Name:HURWITT, HEATHER LYNN (MFT, MHC, & PCC)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:LYNN
Last Name:HURWITT
Suffix:
Gender:F
Credentials:MFT, MHC, & PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4715 NW 53RD AVE STE B
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32653-4812
Mailing Address - Country:US
Mailing Address - Phone:813-928-9140
Mailing Address - Fax:
Practice Address - Street 1:4715 NW 53RD AVE STE B
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32653-4812
Practice Address - Country:US
Practice Address - Phone:813-928-9140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11205101YP2500X
FLIMT3707106H00000X
CA131414106H00000X
FLIMH22532101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist