Basic Information
| Provider Information | |||||||||
| NPI: | 1225476294 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HURLEY | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | MICHAEL | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16305 LARCHWOOD AVE | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441351209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2163377719 | ||||||||
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| Practice Location | |||||||||
| Address1: | 20800 WESTGATE MALL | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | CLEVELAND | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441261323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4403334949 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2013 | ||||||||
| LastUpdateDate: | 06/12/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | C0600273 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.