Provider Demographics
NPI:1194384347
Name:TURNER, KELLY (LLMSW, CAADC)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:
Last Name:TURNER
Suffix:
Gender:F
Credentials:LLMSW, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 W WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-1236
Mailing Address - Country:US
Mailing Address - Phone:517-205-4001
Mailing Address - Fax:517-787-1286
Practice Address - Street 1:2424 W WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-1236
Practice Address - Country:US
Practice Address - Phone:517-205-4001
Practice Address - Fax:517-787-1286
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011012991041C0700X
MI68011093001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical