Provider Demographics
NPI:1104324391
Name:HURDA, JESSICA D (LPC)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:D
Last Name:HURDA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:D
Other - Last Name:CRUMBACKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 W EISENHOWER DR STE A
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-1142
Mailing Address - Country:US
Mailing Address - Phone:717-632-8400
Mailing Address - Fax:717-632-9300
Practice Address - Street 1:100 W EISENHOWER DR STE A
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1142
Practice Address - Country:US
Practice Address - Phone:
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010161101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC010161OtherPROFESSIONAL COUNSELOR LICENSE