Provider Demographics
NPI:1356959092
Name:HURLEY, ALYSSA DANIELLE (LPC)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:DANIELLE
Last Name:HURLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:DANIELLE
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 OLD LYNCHBURG RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-6500
Mailing Address - Country:US
Mailing Address - Phone:434-263-4889
Mailing Address - Fax:
Practice Address - Street 1:71 TANBARK PLZ
Practice Address - Street 2:
Practice Address - City:LOVINGSTON
Practice Address - State:VA
Practice Address - Zip Code:22949-2464
Practice Address - Country:US
Practice Address - Phone:434-263-4889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701009609101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor