Provider Demographics
NPI:1639159130
Name:HURSEY, LASUNDRA WALKER (LCSW)
Entity Type:Individual
Prefix:
First Name:LASUNDRA
Middle Name:WALKER
Last Name:HURSEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405
Mailing Address - Country:US
Mailing Address - Phone:912-459-7653
Mailing Address - Fax:
Practice Address - Street 1:TUTTLE ARMY HEALTH CLINIC
Practice Address - Street 2:
Practice Address - City:HUNTER ARMY AIRFIELD
Practice Address - State:GA
Practice Address - Zip Code:31409
Practice Address - Country:US
Practice Address - Phone:912-435-6633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0044171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical