Provider Demographics
NPI:1427267178
Name:HURLEY, STEPHANIE R (LPCC-S)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:R
Last Name:HURLEY
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:R
Other - Last Name:HENDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC-S
Mailing Address - Street 1:1735 BLOOMINGDALE AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-1760
Mailing Address - Country:US
Mailing Address - Phone:513-477-4523
Mailing Address - Fax:
Practice Address - Street 1:3914 MIAMI RD STE 209
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227
Practice Address - Country:US
Practice Address - Phone:513-440-3134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0008009101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional