Provider Demographics
NPI:1073200457
Name:TURNER-TAYLOR, JENNIFER NICOLE (MSRC, CRC, LCMHCA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:NICOLE
Last Name:TURNER-TAYLOR
Suffix:
Gender:F
Credentials:MSRC, CRC, LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 GOLD CIR
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-8889
Mailing Address - Country:US
Mailing Address - Phone:781-366-3963
Mailing Address - Fax:
Practice Address - Street 1:1004 GOLD CIR
Practice Address - Street 2:
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302-8889
Practice Address - Country:US
Practice Address - Phone:781-366-3963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18623101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health