Provider Demographics
NPI:1619402302
Name:HURST, JOSEPH (LPC)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:HURST
Suffix:
Gender:M
Credentials:LPC
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 1505
Mailing Address - Street 2:
Mailing Address - City:TAHLEQUAH
Mailing Address - State:OK
Mailing Address - Zip Code:74465-1505
Mailing Address - Country:US
Mailing Address - Phone:918-441-7170
Mailing Address - Fax:
Practice Address - Street 1:537 1/2 SEMINARY AVE
Practice Address - Street 2:
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-2627
Practice Address - Country:US
Practice Address - Phone:918-441-7170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-01
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7720101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional