Individual
DR. CAROL E HURLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.D,LCPC
Contact information
Practice address
9728 W. ESCUDA DR., PEORIA, AZ 85382-0950
(406) 240-0191
Mailing address
6 RISING SUN CT LN, SALMON, ID 83467
(406) 240-0191
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1095
MT
101YM0800X
Mental Health Counselor
LH00009128
WA
101YP2500X
Professional Counselor
Primary
#3587
ID
101YP2500X
Professional Counselor
222
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14279432
CAQH
AZ
Enumeration date
10/13/2008
Last updated
04/19/2021
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