Individual provider Active NPI

Michael Reynolds Hurst, MS, LADAC, CEAP, SAP

  • Addiction (Substance Use Disorder) Counselor
  • Las Cruces, NM
National Provider Identifier
1639495740
Registry record updated Nov 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
0128791 Issued in NM
Practice address
1990 E Lohman Ave
Las Cruces, NM 88001-3172
Phone
(575) 636-5260
Fax
(575) 524-1454
NPI assigned
Apr 14, 2010
Last updated
Nov 12, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 0128791 NM Primary

Addresses

Primary practice location

1990 E Lohman Ave
Las Cruces, NM 88001-3172

Mailing address

3621 Sierra Bonita Ave
Las Cruces, NM 88012-0728
Phone (575) 636-5260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0128791NMMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1271203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352678400000",
    "number": "1639495740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 SIERRA BONITA AVE",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880120728",
            "telephone_number": "575-636-5260",
            "fax_number": "575-524-1454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 E LOHMAN AVE",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880013172",
            "telephone_number": "575-636-5260",
            "fax_number": "575-524-1454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURST",
        "first_name": "MICHAEL",
        "middle_name": "REYNOLDS",
        "name_prefix": "Mr.",
        "credential": "MS, LADAC, CEAP, SAP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-14",
        "last_updated": "2012-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "0128791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2012; 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.