Michael Thomas Hurlock, PH.D. LMFT LPC NCC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

001179 Issued in CT

Practice address

9 Dunham Pond Road
Storrs, CT 06268

Phone

(860) 477-0497

Fax

(860) 477-0532

NPI assigned

Aug 6, 2008

Last updated

Dec 15, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260835200000",
    "number": "1639335813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 DUNHAM POND ROAD",
            "city": "STORRS",
            "state": "CT",
            "postal_code": "06268",
            "telephone_number": "860-477-0497",
            "fax_number": "860-477-0532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 DUNHAM POND ROAD",
            "city": "STORRS",
            "state": "CT",
            "postal_code": "06268",
            "telephone_number": "860-477-0497",
            "fax_number": "860-477-0532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURLOCK",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "PH.D. LMFT LPC NCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-06",
        "last_updated": "2009-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "000756",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "001179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008002535",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Storrs, CT
• Providers in Storrs, CT by specialty
• Marriage & Family Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.