Provider Demographics
NPI:1093009714
Name:TURNER, JOHNNIE FIDEL JR (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOHNNIE
Middle Name:FIDEL
Last Name:TURNER
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 VERMONT AVENUE
Mailing Address - Street 2:#219 RHAPSODY
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001
Mailing Address - Country:US
Mailing Address - Phone:202-518-5676
Mailing Address - Fax:
Practice Address - Street 1:2120 VERMONT AVE NW
Practice Address - Street 2:#219 RHAPSODY
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-4039
Practice Address - Country:US
Practice Address - Phone:202-518-5676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-31
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC1349101YP2500X
GALPC001900101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional