Provider Demographics
NPI:1699450395
Name:HURST, ALEC WESLEY (PLPC)
Entity type:Individual
Prefix:
First Name:ALEC
Middle Name:WESLEY
Last Name:HURST
Suffix:
Gender:M
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2515 W ALLEN DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65810-1300
Mailing Address - Country:US
Mailing Address - Phone:417-576-8410
Mailing Address - Fax:
Practice Address - Street 1:2515 W ALLEN DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65810-1300
Practice Address - Country:US
Practice Address - Phone:417-576-8410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023021555101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health