Provider Demographics
NPI:1639650591
Name:HURD, GREGORY MITCHELL (LPC, MHSP)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:MITCHELL
Last Name:HURD
Suffix:
Gender:
Credentials:LPC, MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1167 SPRATLIN PARK DR
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-6205
Mailing Address - Country:US
Mailing Address - Phone:423-467-3600
Mailing Address - Fax:423-467-3644
Practice Address - Street 1:101 LENA DR
Practice Address - Street 2:
Practice Address - City:ROGERSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37857-2951
Practice Address - Country:US
Practice Address - Phone:423-272-9239
Practice Address - Fax:423-272-1803
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7610101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional