Provider Demographics
NPI:1932232477
Name:HURNEY, MICHAEL LEWIS (LCSW-C)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:LEWIS
Last Name:HURNEY
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11501 SEQUOIA LN
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-1469
Mailing Address - Country:US
Mailing Address - Phone:301-595-5135
Mailing Address - Fax:301-931-1974
Practice Address - Street 1:11501 SEQUOIA LN
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-1469
Practice Address - Country:US
Practice Address - Phone:301-595-5135
Practice Address - Fax:301-931-1974
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD105351041C0700X
VA09040046271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG7470001OtherCARE FIRST
MD491650Medicare ID - Type Unspecified