Provider Demographics
NPI:1043687841
Name:HURD, COURTNI ELIZABETH (LCSW)
Entity type:Individual
Prefix:
First Name:COURTNI
Middle Name:ELIZABETH
Last Name:HURD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1357
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-8357
Mailing Address - Country:US
Mailing Address - Phone:315-288-3480
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 1357
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-8357
Practice Address - Country:US
Practice Address - Phone:917-972-9237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-27
Last Update Date:2024-06-05
Deactivation Date:2016-06-02
Deactivation Code:
Reactivation Date:2023-03-30
Provider Licenses
StateLicense IDTaxonomies
NY086211104100000X
UT1304735135011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker