Provider Demographics
NPI:1235476201
Name:TURNER, SAMANTHA C (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:C
Last Name:TURNER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:SAMANTHA
Other - Middle Name:
Other - Last Name:DEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:139 CARIATI BLVD
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06451-3683
Mailing Address - Country:US
Mailing Address - Phone:203-654-5812
Mailing Address - Fax:
Practice Address - Street 1:344 WATERTOWN RD
Practice Address - Street 2:
Practice Address - City:THOMASTON
Practice Address - State:CT
Practice Address - Zip Code:06787-1921
Practice Address - Country:US
Practice Address - Phone:203-819-0789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-11
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2582101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008054442Medicaid