Provider Demographics
NPI:1104365329
Name:HURST, ROZANNE MARIE (LMHC)
Entity type:Individual
Prefix:
First Name:ROZANNE
Middle Name:MARIE
Last Name:HURST
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4809 HAYDEN PL NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-3227
Mailing Address - Country:US
Mailing Address - Phone:505-350-1011
Mailing Address - Fax:
Practice Address - Street 1:333 HIGHWAY 528
Practice Address - Street 2:SUITE 205
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124
Practice Address - Country:US
Practice Address - Phone:505-814-1460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-21
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0190011101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health