Provider Demographics
NPI:1063027837
Name:TURNER, FATIMAH (LSW)
Entity Type:Individual
Prefix:
First Name:FATIMAH
Middle Name:
Last Name:TURNER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 OAKWOOD AVE APT 1C
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07050-3911
Mailing Address - Country:US
Mailing Address - Phone:973-280-4092
Mailing Address - Fax:
Practice Address - Street 1:203 OAKWOOD AVE APT 1C
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07050-3911
Practice Address - Country:US
Practice Address - Phone:973-280-4092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-09
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06343600104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker