Provider Demographics
NPI:1114328457
Name:HURT, SHARON BROOKE (LCPC, ACADC)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:BROOKE
Last Name:HURT
Suffix:
Gender:
Credentials:LCPC, ACADC
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:BROOKE
Other - Last Name:MARSHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC, ACADC
Mailing Address - Street 1:794 EASTLAND DR
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-6856
Mailing Address - Country:US
Mailing Address - Phone:208-734-1281
Mailing Address - Fax:208-734-1282
Practice Address - Street 1:2647 KIMBERLY RD STE 2
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-7976
Practice Address - Country:US
Practice Address - Phone:208-734-1281
Practice Address - Fax:208-734-1282
Is Sole Proprietor?:No
Enumeration Date:2014-09-05
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDACADC13036101YA0400X
IDLCPC7530101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)