KELLY HURST (NPI# 1356971824) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356971824 |
| Entity Type | Individual |
| Full Name | KELLY HURST |
| Credential | PMHMP |
| Practice Address |
23715 Mercantile Rd Ste A203 Beachwood OH 44122-5918 |
| Practice Telephone | 2162922880 |
| Mailing Telephone | 2162922880 |
| Enumeration Date | 2020-01-23 |
| Last Update Date | 2020-07-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WG0000X |
Registered Nurse Specialization: General Practice |
RN.368487 | OH | Nursing Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
RN.382670 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 36100 Euclid Avenue, Suite 400, Willoughby, OH 44094 | 4406026735 | 4409463221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851871040 | Kelly Theim Hurst | Psychologist | 5914 Hubbard Dr, Rockville, MD 20852-4823 | 2018-08-16 |
| 1447657945 | Kelly Hurst | Counselor | 13333 Palmdale Rd, Victorville, CA 92392-9364 | 2014-11-26 |
| 1023425493 | Kelly Hurst | Public Health or Welfare | 25 Deltona Blvd, Saint Augustine, FL 32086-4203 | 2014-07-17 |
| Street Address |
23715 MERCANTILE RD STE A203 |
| City | BEACHWOOD |
| State | OH |
| Zip Code | 44122-5918 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750335261 | Psycho Social Therapies,ltd | Clinic/Center | 23715 Mercantile Rd Ste A203, Beachwood, OH 44122-5918 | 2006-05-20 |
| 1083214936 | Kathleen Yoakum | Social Worker | 23715 Mercantile Rd Ste A203, Beachwood, OH 44122-5918 | 2020-10-29 |
| 1538774732 | Katherine L Guess | Social Worker | 23715 Mercantile Rd Ste A203, Beachwood, OH 44122-5918 | 2020-09-14 |
| 1639705288 | Connie Morgan | Social Worker | 23715 Mercantile Rd Ste A203, Beachwood, OH 44122-5918 | 2020-03-16 |
| 1922658202 | Christina Dawson | Social Worker | 23715 Mercantile Rd Ste A203, Beachwood, OH 44122-5918 | 2019-09-18 |
| 1902462906 | Psycho Social Therapies,ltd | Clinic/Center | 23715 Mercantile Rd Ste A203, Beachwood, OH 44122-5918 | 2019-05-15 |
| 1245896299 | Michele Tanchak | Social Worker | 23715 Mercantile Rd Ste A203, Beachwood, OH 44122-5918 | 2019-05-15 |
| 1053874859 | Diana L Hartwig | Social Worker | 23715 Mercantile Rd Ste A203, Beachwood, OH 44122-5918 | 2019-04-09 |
| 1306302583 | Nicole Holmes | Social Worker | 23715 Mercantile Rd Ste A203, Beachwood, OH 44122-5918 | 2019-02-13 |
| 1871064881 | Barbara L Eden | Social Worker | 23715 Mercantile Rd Ste A203, Beachwood, OH 44122-5918 | 2018-12-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760083174 | Sophia Denise Moncrieffe-jordan | Nurse Practitioner | 23511 Chargin Blvd, Apt. E312, Beachwood, OH 44122 | 2020-11-03 |
| 1447864400 | Resilient Bodies LLC | Massage Therapist | 24300 Chagrin Blvd #312, Beachwood, OH 44122 | 2020-09-06 |
| 1215576087 | Hni Emergency Services of Ohio, LLC | Nurse Practitioner | 22501 Chagrin Blvd, Beachwood, OH 44122 | 2019-12-27 |
| 1013555648 | Barbara L Ekelman Phd Inc | Psychologist | 24100 Chagrin Blvd, Suite 385, Beachwood, OH 44122 | 2019-12-13 |
| 1417599770 | Janise Moore | Technician | 19600 Gladstone Rd, Warrensville Hts, OH 44122 | 2019-10-08 |
| 1598312704 | Nizar Andria | Student in an Organized Health Care Education/Training Program | Cedar Rd 27050, Apartment 515, Beachwood, OH 44122 | 2019-08-22 |
| 1437703998 | Malinda Ann Davis | Social Worker | 20600 Chagrin Blvd Suite 320, Shaker Heights, OH 44122 | 2019-08-01 |
| 1891265864 | Karlan Champagne | Case Management | 23215 Commerence Park, 306, Beachwood, OH 44122 | 2018-12-03 |
| 1952896565 | Donna Pinkney | Counselor | 20550 University Blvd Apt 206, Shaker Hts, OH 44122 | 2018-06-26 |
| 1255825857 | Elizabeth Anne Donathan | Registered Nurse | 4100 Warrensville Center Rd Ste 101, Warrensville Heights, OH 44122 | 2018-06-18 |
| Find all providers in zip 44122 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740811231 | Change Unlimited | Nurse Practitioner | 3695 Green Rd Ste 1273, Beachwood, OH 44122-7900 | 2020-02-03 |
| 1457635229 | Sandra Wolfe Lavelle | Nurse Practitioner | 23625 Commerce Park Ste 180, Beachwood, OH 44122-5847 | 2011-09-28 |
| 1982118105 | Kelly Caryn Ausman | Nurse Practitioner | 25550 Chagrin Blvd Ste 200, Beachwood, OH 44122-4640 | 2017-11-27 |
| 1932627825 | Joseph Fernando Keppler | Nurse Practitioner | 29525 Chagrin Blvd, Beachwood, OH 44122-4644 | 2017-08-31 |
| 1427419845 | Kuwanna Deaver | Nurse Practitioner | 3401 Enterprise Pkwy, Beachwood, OH 44122-7341 | 2016-03-12 |
| 1689941262 | Monica Halter | Nurse Practitioner | 24800 Highpoint Rd, Beachwood, OH 44122-6052 | 2011-11-26 |
| 1285747972 | Laura Marie Dehelian | Nurse Practitioner | 24800 Highpoint Rd, Suite B, Beachwood, OH 44122-6041 | 2006-08-16 |
| 1144269465 | Katherine Proehl | Nurse Practitioner | 24800 Highpoint Rd, Beachwood, OH 44122-6041 | 2006-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770184707 | Joanna Sue Tricaso-torrence | Nurse Practitioner | 3567 Reserve Commons Dr Ste 100, Medina, OH 44256-5344 | 2020-11-05 |
| 1427658368 | Greta Katherine Heckmann | Nurse Practitioner | 2508 Beechmont Ave Apt 43, Cincinnati, OH 45230-1240 | 2020-10-29 |
| 1083213078 | Smtia Sonali Carpenter | Nurse Practitioner | 9509 Knarwood Ct, Pickerington, OH 43147-8106 | 2020-10-20 |
| 1255939054 | Jessica Kincaid | Nurse Practitioner | 3921 Clareridge Dr Unit B, Toledo, OH 43623-3380 | 2020-10-14 |
| 1801493531 | Kasey Zink | Nurse Practitioner | 5934 Creek Rd Se, Washington Court House, OH 43160-8778 | 2020-10-06 |
| 1861099806 | Taylor Buck | Nurse Practitioner | 158 Rock Creek Dr, Delaware, OH 43015-2260 | 2020-10-02 |
| 1598371296 | Peace of Mind Therapeutics LLC | Nurse Practitioner | 5170 Pebble Brook Dr, Englewood, OH 45322-3632 | 2020-09-17 |
| 1003421827 | Rachel Bird | Nurse Practitioner | 2900 Presidential Dr Ste 100, Beavercreek, OH 45324-6502 | 2020-09-09 |
| 1740894880 | Angel M Davis | Nurse Practitioner | 11210 Navajo Ln Apt 203, Parma Heights, OH 44130-9045 | 2020-09-05 |
| 1548873680 | Nicollette Pizzoferrato | Nurse Practitioner | 600 W Goodale St Apt 261, Columbus, OH 43215-1904 | 2020-08-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.