Provider Demographics
NPI:1972158699
Name:HURST, EMILY (LMFT-A)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:HURST
Suffix:
Gender:F
Credentials:LMFT-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 OLMSTED PARK PL APT J
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-5600
Mailing Address - Country:US
Mailing Address - Phone:336-899-4606
Mailing Address - Fax:
Practice Address - Street 1:7745 BALLANTYNE COMMONS PKWY STE 102
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-2442
Practice Address - Country:US
Practice Address - Phone:704-995-0342
Practice Address - Fax:704-943-0707
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-08
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12160A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist