Provider Demographics
NPI:1295188092
Name:TURNER, JANUARY L (MA, LMHC)
Entity Type:Individual
Prefix:MRS
First Name:JANUARY
Middle Name:L
Last Name:TURNER
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4071 NEW HAMPSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:FL
Mailing Address - Zip Code:32033-2124
Mailing Address - Country:US
Mailing Address - Phone:904-501-7578
Mailing Address - Fax:
Practice Address - Street 1:88 RIBERIA ST
Practice Address - Street 2:SUITE 150
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32084-3300
Practice Address - Country:US
Practice Address - Phone:904-501-7578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH14185101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health