Kelly Wray Hurley, LPC
Counselor, Mental Health in Phoenix, AZ. Individual provider (NPI-1).
NPI number1003979949
StatusActive
Last updated in NPPESJan 22, 2024
Details
- NPI
- 1003979949
- Entity type
- Individual (NPI-1)
- Name
- Ms. Kelly Wray Hurley
- Credential
- LPC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 19, 2006
- Certification date
- Jan 22, 2024
- Last updated
- Jan 22, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- Medicare opt-out
- May 27, 2024 to May 27, 2028
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | LPC-12363 | AZ | Yes |
| 101YM0800X | Counselor, Mental Health | LPC12363 | AZ |
Practice location
7220 N 16th St Suite GPhoenix, AZ 85020
Phone 480-707-8172
Mailing address
7220 N 16th St Ste GPhoenix, AZ 85020-5253
Phone 480-707-8172
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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