Provider Demographics
NPI:1730889916
Name:HURST, JESSICA LEIGH (MS, NCC, LPC-MHSP)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LEIGH
Last Name:HURST
Suffix:
Gender:F
Credentials:MS, NCC, LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 CARTER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WESTMORELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37186-5111
Mailing Address - Country:US
Mailing Address - Phone:404-428-1765
Mailing Address - Fax:
Practice Address - Street 1:1604 WESTGATE CIR STE 240
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-8578
Practice Address - Country:US
Practice Address - Phone:554-361-5543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-07
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6524101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional